低温机械灌注与单纯冷保存供肾对肾移植预后影响的Meta分析

发布时间：2018-02-28 00:54

本文关键词： 肾移植器官保存器官移植 Meta-分析组织构建组织工程保存低温机械灌注冷保存 Meta分析国家自然科学基金　出处：《中国组织工程研究》2015年42期 　论文类型：期刊论文

【摘要】：背景:目前,国内外低温机械灌注与冷保存对肾移植预后影响的文章比较多,但结论各异,且由于大多单个研究样本量存在局限,对低温机械灌注的优缺点缺乏客观评价。目的:比较低温机械灌注与冷保存对肾移植预后的影响。方法:计算机检索Pub Med、sino Med、EMbase、Web of Science、the Cochrane Central Register of Controlled Trials(CENTRAL)、万方数据库及中国知网,查找并筛选出所有比较低温机械灌注与冷保存对肾移植预后影响的随机对照试验(Randomized Controlled Trial,RCT),同时手检纳入文献的参考文献,检索时限均为建库至2015年3月4日。按纳入排除标准由2位评价者独立进行RCT的筛选、资料提取和质量评价后,采用RevM an(5.3.0版)软件进行Meta分析,并采用GRADEpro3.6软件进行证据质量评价。结果与结论:共纳入文献6篇,低温机械灌注保存供肾共619例,冷保存保存供肾共620例。结果显示:低温机械灌注组原发性移植物无功能发生率、功能性移植肾功能延迟恢复发生率、移植肾功能延迟恢复发生率均显著低于冷保存组(P0.05或0.01)。患者1年生存率、移植物1年存活率差异均无显著性意义(P0.05)。结果表明低温机械灌注保存供体只能降低肾移植后近期并发症的发生率,维护肾脏功能,但无法提高患者1年生存率和移植物1年存活率,相比较冷保存的保存方式,低温机械灌注对供体器官的保护无长期优势。
[Abstract]:Background: at present, domestic and international influence of low temperature mechanical perfusion and cold preservation on the prognosis of renal transplantation are many, but the conclusion is different, and because most of the single sample size limitations, lack of objective evaluation of the advantages and disadvantages of low temperature mechanical perfusion. Objective: To compare the effects of irrigation and low temperature mechanical injection of cold preservation on the prognosis of renal transplantation. Methods: We searched the Pub Med, Sino Med, EMbase Web, of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), Wanfang database and Chinese HowNet, searching and screening all randomized controlled trials of relatively low mechanical perfusion and cold preservation on the prognosis of renal transplantation (Randomized Controlled Trial, RCT), at the same time hand inspection into literature references were searched from inception to March 4, 2015. Screening according to inclusion and exclusion criteria by 2 reviewers independently of RCT, data extraction and quality evaluation After using RevM an (5.3.0) Meta analysis software, and the evidence for the quality evaluation by GRADEpro3.6 software. Results and conclusion: a total of 6 articles, cold machine perfusion preservation of donor kidney in 619 cases, cold preservation of donor kidney in 620 cases. The results showed that low temperature mechanical perfusion group primary nonfunction the incidence of graft function, delayed graft function recovery rate, the incidence of delayed graft function were significantly lower than those in the cold preservation group (P0.05 or 0.01). The 1 year survival rate of patients and graft survival rate of 1 years there was no significant difference (P0.05). The results show that the low temperature mechanical perfusion preservation of donor only to reduce the complications after renal transplantation, the incidence of maintenance of renal function, but can not improve the 1 year survival rate of patients and graft survival rate of 1 years, compared with cold storage preservation, low temperature mechanical perfusion on donor organ protection without long-term advantage.

【作者单位】：武汉大学中南医院武汉大学肝胆疾病研究院武汉大学移植医学中心移植医学技术湖北省重点实验室;中南大学湘雅三医院卫生部移植医学工程技术研究中心;武汉大学公共卫生学院流行病学教研室;武汉大学病毒学国家重点实验室;
【基金】：国家自然科学基金新疆联合项目(U1403222) 湖北省卫生计生科研项目(WJ2015MB037) 中央高校基本科研业务基金(2042015kf1015)~~
【分类号】：R699.2

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