Clinical Transplantation Of Liver And Kidney Organ From Donation After China Citizen’s Death

Objective By analyzing the voluntary donation of liver and kidney organs and series of cases of clinical organs transplantation(LT and KT)in the First Affiliated Hospital of Anhui Medical University to investigate the clinical efficacy and experience of organ donation and organ transplantation after the death of China citizens.Methods Retrospective analysis of successful implementation of 20 cases of China citizen’s after the death of donor organ cases and 49 cases of liver and kidney transplant recipients clinical data in our hospital from March 2012 to December 2016,17 were donation after brain and cardiac death(C-Ⅲ)and 3 were donation after cardiac death(C-Ⅱ),there were 16 livers and 40 kidneys,the acquisition of all organs was performed by rapid harvesting technique of abdominal organs.In addition to the 4 kidneys were deprecated,the rest of the organs were assigned to the organ transplant center of the receptor waiting list by the Chinese human organ allocation and sharing computer system and used in the clinical organ transplantation.Single factor analysis was used to analyze the clinical efficacy of liver and kidney transplantation,the related factors affecting the efficacy of organ transplantation were summarized according to the probability of complications of the recipient and the situation of the donor.Results As of December 2016,our hospital OPO had accomplished 20 cases of China donation after citizen’s death.Among them,4 kidneys were deprecated due to: 1 kidney was found small cyst with insufficiency;2 kidneys with long-term hypoxemia,abdominal organs such as kidney caused by insufficient oxygen supply long timeischemia and hypoxia,a large number of micro thrombosis;1 kidney was found artery stenosis.49 cases of citizens accepted organ donation after China citizen’s death,with these donated organs,15 livers were used for LT,31 kidneys were used for KT,1 liver and 1 kidney for SLKT,2 cases of en bloc pediatric kidney transplantation to adult recipient.All the procedures of transplantation were performed successfully.During the perioperative period of LT recipients,1 case died of postoperative bleeding,infection and following multiple organ failure,2 cases died of multiple organ failure.The recipients were followed up for 4~40 months,and the existing recipients recovered successfully with good prognosis.During the perioperative period of KT recipients,Cr was normal in the 15 cases donors,2 of 26(7.7%)recipients developed Delayed graft function(DGF)and received postoperative dialysis(average 6 times),the average time of recovery normal of serum Cr was 16.4 d.Severe infection occurred in 4 cases,including 3 cases developed multiple organ failure and died after 15,54,60 d respectively and 1 case cured.The abnormal Cr(≥133 μmol/L)in the 3 donor cases were 151,212 and 238 μ mol/L,Delayed graft function(DGF)occurred in 4 of 5(80.0%)recipients.All the patients received dialysis treatment after operation(average6.5 times),the average time of recovery normal of serum Cr was 32.3 d among them,2cases died of severe infection and multiple organ failure after 38 d and 70 d respectively;1 case recovered,the overall mortality rate was 16.1%.The incidence of Delayed graft function(DGF)and the time required for the recovery of serum Cr after donor Cr normal recipient surgery were significantly lower than those donor Cr abnormality(P <0.05).The recipients were followed up for 1~57 months,pulmonary infection occurred in 7 recipients and 2 suffered from renal insufficiency.The kidney function of the rest recipients recovered successfully with good prognosis.One case of en bloc pediatric kidney transplantation in adult recipients,occurred heart failure and severe pulmonary infection and died of postoperative 22 d,another case and SLKT recipients recovered successfully and none suffered major surgical complications.Conclusion(1)The technique of rapid abdominal organs procurement was used in these cases to obtain liver and kidney and is helpful to improve the utilization rate of limited organs and enlarge the source of organs.(2)For donor organs function evaluation and maintenance is to obtain the high quality the basis of donor organs.