心脏死亡后捐献角膜用作穿透性角膜移植术供体的安全性研究
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国家自然科学基金(No. 81200661,81470606); 湖北省自然科学基金(No. 2010CDB09802)


Security research of cardiac death donation corneas used as penetrating keratoplasty grafts
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National Natural Science Foundation of China(No.81200661, 81470606); Natural Science Foundation of Hubei Province(No.2010CDB09802)

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    摘要:

    目的:探讨心脏死亡后捐献(donation after cardiac death,DCD)角膜供体行穿透性角膜移植的安全性。

    方法:按照时间先后顺序,采用DCD供体角膜行穿透性角膜移植术,术后3~4mo检测角膜植片内皮细胞密度及最佳矫正视力。

    结果:共统计14例26眼DCD角膜供体纳入本研究。供体年龄0.5~61(平均38.3±15.6)岁; 死亡原因包括脑外伤9例,心肌梗塞2例,脑干出血2例,呼吸循环衰竭1例。14例DCD捐献者28眼,因2眼暴露性角膜炎用作科学研究,共26眼用于穿透性角膜移植。所有患者手术过程顺利,手术后3~4mo未发生排斥反应,角膜植片保持透明。手术后3~4mo角膜内皮细胞密度794~4 347(平均2 305±827)个/mm2 ,其中低于1 000个/mm2者1例(3.8%),1 000~2 000个/mm2者9例(34.6%),大于2 000个/mm2者16例(61.5%)。26例角膜移植受者年龄20~80(平均40.7±17.1)岁。手术前最佳矫正视力为光感(+)~0.08(平均0.027±0.024); 手术后3~4mo最佳矫正视力为0.2~0.8(平均0.52±0.182),两者比较差异有显著统计学意义(t=3.96,P<0.01)。

    结论:DCD捐献角膜用作穿透性角膜移植供体具有较高的安全性。

    Abstract:

    AIM: To test the safety of using cardiac death donation(DCD)corneas for penetrating keratoplasty surgery graft.

    METHODS: In chronological order, suing DCD corneas penetrating keratoplasty, corneal endothelial cell density and best corrected visual acuity(BCVA)were tested 3~4mo after surgery.

    RESULTS: A total of 14 cases of DCD while 26 corneas were included in this study. Donors age ranged 0.5~61 years, averagely 38.3±15.6 years. Causes of death included that 9 cases of traumatic brain injury, 2 cases myocardial infarction, 2 cases brain stem hemorrhage, 1 case of respiratory and circulatory failure. All 26 patients underwent penetrating keratoplasty, no rejection occurred and all grafts were transparent 3~4mo after surgery. Three to four months after surgery, corneal endothelial cell density ranged 794~4 347/mm2, averaged 2 305±827/mm2, within which was only one case was lower than 1 000/mm2(3.8%), while 9 cases ranged from 1 000~2 000/mm2(34.6%), 16 cases were higher than 2 000/mm2(61.5%). The age of all the 26 receipts were from 20~80 years, mean 40.7±17.1 years. BCVA before surgery was light perception positive to 0.08, with an average 0.027±0.024. Three to four months after surgery, BCVA were 0.2~0.8, with an average 0.52±0.182 in contrast(t=3.96, P<0.001).

    CONCLUSION: DCD donated corneas could be used for penetrating keratoplasty graft with high security.

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徐晶,张虹,蒋继贫,等.心脏死亡后捐献角膜用作穿透性角膜移植术供体的安全性研究.国际眼科杂志, 2015,15(2):317-319.

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  • 收稿日期:2014-10-04
  • 最后修改日期:2015-01-13
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  • 在线发布日期: 2015-01-30
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