Clinical evaluation value of donor kidney biopsy in extracorporeal membrane oxygenation-supported circulatory failure donors combined with acute kidney injury

doi:10.3877/cma.j.issn.1674-3903.2025.03.012

Abstract

Key words: Extracorporeal membrane oxygenation, Acute kidney injury, Donor kidney biopsy, Renal transplantation, Delayed graft function

jinquan Liu, Shuxian Wang, Shuai Feng, Jianlei Ji, Chuanshen Xu. Clinical evaluation value of donor kidney biopsy in extracorporeal membrane oxygenation-supported circulatory failure donors combined with acute kidney injury[J]. Chinese Journal of Transplantation(Electronic Edition), 2025, 19(03): 181-184.

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References 24

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分期	血清肌酐或肾小球滤过率	尿量
1期	血清肌酐升高≥26.5 μmol/L或升高1.5~1.9倍基线值	<0.5 mL·kg^－1·h^－1持续6~12 h
2期	血清肌酐升高2.0~2.9倍基线值	<0.5 mL·kg^－1·h^－1持续≥12 h
3期	血清肌酐升高≥3倍基线值，或血清肌酐≥353.6 μmol/L，或需启动肾脏替代治疗，eGFR下降至<35 mL·min^－1·(1.73 m²)^－1	<0.3 mL·kg^－1·h^－1持续≥24 h或无尿≥12 h

分期	血清肌酐或肾小球滤过率	尿量
1期	血清肌酐升高≥26.5 μmol/L或升高1.5~1.9倍基线值	<0.5 mL·kg^－1·h^－1持续6~12 h
2期	血清肌酐升高2.0~2.9倍基线值	<0.5 mL·kg^－1·h^－1持续≥12 h
3期	血清肌酐升高≥3倍基线值，或血清肌酐≥353.6 μmol/L，或需启动肾脏替代治疗，eGFR下降至<35 mL·min^－1·(1.73 m²)^－1	<0.3 mL·kg^－1·h^－1持续≥24 h或无尿≥12 h

供者编号	年龄(岁)	原发病	心肺复苏时间(min)	ECMO支持时间(d)	是否接受CRRT	血压(mmHg，收缩压/舒张压)		去甲肾上腺素(μg·kg^－1·min^－1)		多巴胺(μg·kg^－1·min^－1)		血清肌酐(μmol/L)		尿量(mL·kg^－1·h^－1)
供者编号	年龄(岁)	原发病	心肺复苏时间(min)	ECMO支持时间(d)	是否接受CRRT	T1	T2	T1	T2	T1	T2	T1	T2	T1(时间^*)	T2
1	39	TBI	10	5.1	是	63~81/37~42	99~112/55~61	1.1~1.9	0.3~0.5	20~30	7~10	312~414	91~127	0.1~0.2(>24 h)	0.2~0.4
2	57	HIE	－	2.5	是	55~76/36~40	96~107/59~67	1.3~1.5	0.1~0.4	20~26	5~7	296~351	151~232	0.0~0.3(>24 h)	0.4~0.5
3	28	TBI	－	2.2	是	67~95/43~52	102~112/61~76	1.2~1.7	0.2~0.4	21~24	5~9	214~301	172~193	0.1~0.3(>24 h)	0
4	29	HIE	15	2.4	是	58~82/31~46	95~111/63~71	1.9~2.5	0.1~0.7	23~27	6~9	196~249	92~117	0.2~0.3(>12 h)	0.2~0.5
5	55	脑梗死	20	7.3	是	51~61/41~49	89~116/52~65	1.1~2.3	0.3~0.5	24~29	4~10	119~225	132~189	0.1~0.4(>12 h)	0.2~0.3
6	53	TBI	－	1.6	是	77~89/46~52	99~122/61~74	1.7~2.1	0.4~0.8	21~25	8~15	152~161	172~226	0.1~0.2(>12 h)	0.3~0.4
7	38	TBI	－	1.9	是	64~93/41~49	107~127/54~83	1.2~2.5	0.6~0.8	22~23	9~13	386~421	159~953	0.0(>12 h)	0

供者编号	年龄(岁)	原发病	心肺复苏时间(min)	ECMO支持时间(d)	是否接受CRRT	血压(mmHg，收缩压/舒张压)		去甲肾上腺素(μg·kg^－1·min^－1)		多巴胺(μg·kg^－1·min^－1)		血清肌酐(μmol/L)		尿量(mL·kg^－1·h^－1)
供者编号	年龄(岁)	原发病	心肺复苏时间(min)	ECMO支持时间(d)	是否接受CRRT	T1	T2	T1	T2	T1	T2	T1	T2	T1(时间^*)	T2
1	39	TBI	10	5.1	是	63~81/37~42	99~112/55~61	1.1~1.9	0.3~0.5	20~30	7~10	312~414	91~127	0.1~0.2(>24 h)	0.2~0.4
2	57	HIE	－	2.5	是	55~76/36~40	96~107/59~67	1.3~1.5	0.1~0.4	20~26	5~7	296~351	151~232	0.0~0.3(>24 h)	0.4~0.5
3	28	TBI	－	2.2	是	67~95/43~52	102~112/61~76	1.2~1.7	0.2~0.4	21~24	5~9	214~301	172~193	0.1~0.3(>24 h)	0
4	29	HIE	15	2.4	是	58~82/31~46	95~111/63~71	1.9~2.5	0.1~0.7	23~27	6~9	196~249	92~117	0.2~0.3(>12 h)	0.2~0.5
5	55	脑梗死	20	7.3	是	51~61/41~49	89~116/52~65	1.1~2.3	0.3~0.5	24~29	4~10	119~225	132~189	0.1~0.4(>12 h)	0.2~0.3
6	53	TBI	－	1.6	是	77~89/46~52	99~122/61~74	1.7~2.1	0.4~0.8	21~25	8~15	152~161	172~226	0.1~0.2(>12 h)	0.3~0.4
7	38	TBI	－	1.9	是	64~93/41~49	107~127/54~83	1.2~2.5	0.6~0.8	22~23	9~13	386~421	159~953	0.0(>12 h)	0

供者编号	供肾侧别	肾小球数量(个)	肾小球病变	肾小管病变	间质改变	血管病变
1	左	21	无纤维化或硬化	上皮细胞水肿	少量慢性炎性细胞浸润	小血管扩张充血
	右	17	无纤维化或硬化	上皮细胞水肿	少量慢性炎性细胞浸润	小血管扩张充血
2	左	12	1个硬化	嗜酸性变	－	－
	右	20	无硬化	嗜酸性变	－	－
3	左	31	弥漫性血栓、缺血性坏死	急性损伤，肾小管上皮细胞坏死、刷状缘脱落	－	小动脉血栓
	右	19	弥漫性血栓、缺血性坏死	急性损伤，肾小管上皮细胞坏死、刷状缘脱落	－	小动脉血栓
4	左	23	无纤维化或硬化	轻度水肿，局灶性肾小管上皮凝固性坏死	－	－
	右	21	无纤维化或硬化	轻度水肿，局灶性肾小管上皮凝固性坏死	－	－
5	左	26	轻微病变	急性损伤，上皮细胞水肿	－	－
	右	18	轻微病变	急性损伤，上皮细胞水肿	－	－
6	左	17	7个纤维硬化	红细胞管型、萎缩	30%纤维化、炎性细胞浸润	－
	右	21	8个纤维硬化	上皮细胞扁平、刷状缘脱落	10%纤维化、炎性细胞浸润	－
7	左	18	无硬化	嗜酸性变、透明管型	淋巴细胞浸润	－
	右	24	无硬化	嗜酸性变、透明管型	淋巴细胞浸润	－

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受者编号	年龄(岁)	性别	ESRD原因	供肾来源	术后7 d内需透析	术后是否发生DGF	术后是否发生PGD	术后是否发生排斥反应
1	34	女	IgA肾病	供者1左肾	是	是	否	否
2	39	女	高血压	供者1右肾	是	是	否	否
3	44	男	高血压	供者2左肾	是	是	否	否
4	68	男	高血压	供者2右肾	否	是	否	否
5	53	男	糖尿病	供者4左肾	是	是	否	否
6	34	女	高血压	供者4右肾	否	否	否	否
7	34	男	高血压	供者5左肾	是	是	否	否
8	33	女	糖尿病	供者5右肾	是	－	－	－
9	53	男	糖尿病	供者7左肾	否	是	否	否
10	46	女	高血压	供者7右肾	是	是	否	否

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