| Objective:The aim of this study was to investigate the effects of Ulinastatin-pretreated of donors after controllable cardiac death on renal transplant recipients’ postoperative renal function.Methods:90 cases of organ donors after controllable cardiac death and 174 cases of renal transplant recipients in the first Bethune Hospital of Jilin University from July 2018 to December 2019 were selected.The donors were randomly divided into three groups: U1 group: Ulinastatin of 5,000 unites/kg was used intraoperatively;U2 group: Ulinastatin of 10,000 unites/kg was used intraoperatively;Control group: no Ulinastatin was used intraoperatively,instead an equal volume of normal saline was given.Serum creatinine,urea nitrogen,estimated glomerular filtration rate(eGFR)of one day preoperatively and one to seven days postoperatively,and hourly urine volumes as well as postoperative delayed graft function(DGF)were collected.Results were statistically analyzed using IBM SPSS 25.0 software.Results:1.Donors’ data: there were no significant differences of the three groups in gender,age,BMI,causes of death,whether cardiopulmonary resuscitation had been performed or not before organ removal,mean arterial pressure(MAP)entering the operating room,heart rates,and the changes of serum creatinine,urea nitrogen and sodium of the last preoperative venous blood(P>0.05).2.Recipients’ data: there were no statistical differences in the general data of the three groups,such as gender,age,BMI,warm ischemia time,cold ischemia time,primary diseases,dialysis modes,dialysis time and renal artery anastomosis mode(P > 0.05).There were no significant differences in mean arterial pressure(MAP)among the three groups(P>0.05)at each time point(before anesthesia,after anesthesia,when renal artery was opened,and postoperatively).3.Various postoperative indexes of recipients: serum creatinine of the three groups of recipients decreased significantly within 7 days postoperatively,serum creatinine in U1 and U2 groups decreased more greatly than that in the control group,but the difference between the three groups was not statistically significant(P> 0.05).The urea nitrogen levels of the three groups of recipients decreased and then rebounded,urea nitrogen in U1 and U2 groups decreased more greatly than that in the control group,and the difference among the three groups was not statistically significant(P>0.05).The hourly urine volume showed a decreasing trend in the three groups of recipients within 7 days postoperatively.The hourly urine volumes in U1 group and U2 group on the first day were higher than that in the control group,and the difference was statistically significant(P<0.05).The hourly urine volume on the third day postoperatively was higher in U2 group than that in U1 group,and the difference was statistically significant(P<0.05).The hourly urine volume on the 5th day postoperatively in U2 group was higher than that in U1 group,and the difference was statistically significant(P<0.05).The hourly urine volume on the 6th day postoperatively of U2 group was higher than that of U1 group or control group,and the difference was statistically significant(P<0.05).There were no significant differences in hourly urine volumes among the three groups on the other days(P > 0.05).The eGFR of the U1 group and U2 group was higher than that of the control group within 7 days postoperatively.The eGFR of the U1 group was higher than that of the control group on the 2nd day postoperatively,and the difference was statistically significant(P<0.05).There was no significant difference in the eGFR of the three groups of recipients for the rest of the time.The percentages of DGF in control group,U1 group and U2 group were 10.5%,8.5% and 6.9% respectively,but the difference was not statistically significant(P > 0.05).Conclusion:The use of ulinastatin 5,000U/kg or 10,000U/kg one-time central intravenous injection in controlled cardiac death,the renal functions of recipients can be protected to some extent. |
PDF Full Text Request