Journal of Jilin University(Medicine Edition) ›› 2021, Vol. 47 ›› Issue (2): 469-476.doi: 10.13481/j.1671-587X.20210228

• Research in clinical medicine • Previous Articles     Next Articles

Effect of ulinastatin pretreatment on postoperative recipients’ renal function in operation of donation after controllable cardiac death

Yangyang SONG1,Tingting LIN1,Qianyan HE2,Huanqiu LIU1(),Yanhua FENG1()   

  1. 1.Department of Anesthesiology,First Hospital,Jilin University,Changchun 130021,China
    2.Department of Neurology,First Hospital,Jilin University,Changchun 130021,China
  • Received:2020-05-22 Online:2021-03-28 Published:2021-03-25
  • Contact: Huanqiu LIU,Yanhua FENG E-mail:chunqiu2002@163.com;fengyanhua77@163.com

Abstract: Objective

To investigate the effects of ulinastatin pretreatment in the operation of the controllable donation after cardiac death(DCD) on the postoperative renal function of the recipients.

Methods

A total of 90 cases of controllable DCD donors and 174 cases of renal transplant recipients were selected. The donors were randomly divided into three groups. U1 group: 5 000 U·kg-1 ulinastatin was used preoperatively; U2 group: 10 000 U·kg-1 ulinastatin was used preoperatively; control group: no ulinastatin was used preoperatively, instead of an equal volume of normal saline. The levels of serum creatinine and blood urea nitrogen of the recipients before and 1~7 d after operation were detected, the estimated glomerular filtration rate (eGFR) was calculated, the hourly urine volumes were recorded, and the postoperative incidence rates of delayed graft function (DGF) were calculated.

Results

The hourly urine volume showed a decreasing trend in the three groups within 7 d postoperatively. The hourly urine volumes in U1 group and U2 group on the first day after operation were higher than that in control group (P<0.05); the hourly urine volume of the recipients on the third day after operation in U2 group was higher than that in U1 group (P<0.05); the hourly urine volume of the recipients on the 5th day after operation in U2 group was higher than that in U1 group (P<0.05); the hourly urine volume of the recipients on the 6th day after operation in U2 group was higher than those in U1 group and control group (P<0.05). There were no significant differences in hourly urine volumes among three groups on the other days (P>0.05). The eGFR of the recipients in U1 group and U2 group were higher than those in control group within 7 d after operation (P<0.05); the eGFR of the recipientsof the recipients in U1 group was higher than that in control group on the 2nd day after operation (P<0.05). There were no significant differences in the eGFR among three groups for the rest of time. The serum creatinine levels of the recipients in three groups were significantly decreased; the serum creatinine levels of the recipients in U1 and U2 groups were decreased more greatly than control group, but the differences among three groups were not statistically significant (P>0.05). The blood urea nitrogen levels of the recipients in three groups were decreased first and then increased, and the blood urea nitrogen levels of the recipients in U1 and U2 groups were decreased more greatly than control group, but the differences among three groups were not statistically significant (P>0.05). The incidence rates of DGF after operation in control group, U1 group and U2 group were 10.5%, 8.5% and 6.9%, respectively, but the differences among three groups were not statistically significant (P>0.05).

Conclusion

Ulinastatin pretreatment of controllable DCD can promote the early recovery of urine volume of recipients after renal transplantation and protect the renal function to some extent.

Key words: ulinastatin, renal transplantation, donation after cardiac death, ischemia reperfusion injury, pretreatment, renal function

CLC Number: 

  • R617