Preliminary exploration of the feasibility and safety of diaphragm preservation during combined liver and kidney deceased donor procurements
10.3760/cma.j.cn421203-20240408-00083
- VernacularTitle:保留供者膈肌的肝肾联合获取可行性与安全性的初步探讨
- Author:
Feixiong PANG
1
;
Jiazhi LI
1
;
Shengsong OU
1
;
Guo RAN
1
;
Yanhua LAI
1
Author Information
1. 广西壮族自治人民医院移植科，广西重大传染性疾病重症救治临床医学研究中心，广西卫生健康委员会门静脉高压防治研究重点实验室，南宁 530021
- Publication Type:Journal Article
- Keywords:
Diaphragm;
Donor;
Combined liver and kidney deceased donor procurement;
Donor derived infection
- From:
Chinese Journal of Organ Transplantation
2025;46(6):454-460
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility and safety of the combined liver and kidney procurement technique with preservation of the donor diaphragm.Methods:A retrospective study was conducted on the clinical data of 135 donors with pulmonary infection who underwent combined liver and kidney procurement and their corresponding 370 recipients in the Department of Transplantation, Guangxi Zhuang Autonomous Region People's Hospital from January 2021 to August 2023. According to whether the donor diaphragm was resected during procurement, the donors were divided into diaphragm preservation group (67 cases) and diaphragm resection group (68 cases). The t-test and chi-square test were used to compare the baseline characteristics of the donors, donor procurement time, surgical injury to organs, donor-derived infection (DDI), delayed graft function (DGF), primary non-function (PNF), and perioperative death between the two groups.Results:There were no statistically significant differences in age, sex, body mass index, number of organs procured, number of organs transplanted, number of organs discarded, or positive rate of sputum cultures for different strains between the two groups (all P>0.05). The donor procurement time was (46.70±12.61) min in the diaphragm preservation group and (45.79±12.78) min in the diaphragm resection group, with no statistically significant difference ( P=0.679). No surgical injuries to other abdominal organs (such as intestines or, in the diaphragm resection group, the lungs) occurred during procurement. After transplantation, the incidence of delayed graft function in kidney recipients was 7.32% (9/123) in the diaphragm preservation group and 11.67% (14/120) in the diaphragm resection group, with no statistically significant difference between the two groups ( P=0.279). The incidence of DDI was 0 in the diaphragm preservation group and 7.07% (13/184) in the diaphragm resection group, showing a statistically significant difference ( P<0.001). No cases of primary non-function or perioperative death occurred in either group. Conclusion:Compared with the conventional method, the combined liver and kidney procurement technique that preserves the donor diaphragm does not significantly increase operative time, organ injury, delayed graft function, primary non-function, or perioperative mortality. It significantly reduces the incidence of donor-derived infections and is worthy of clinical promotion and application.
