移植肾超急性排斥反应(附6例报告)

HYPERACUTE REJECTION REACTION IN KIDNEY TRANSPLANTATION (REPORT OF 6 CASES)

目的 :提高肾移植超急性排斥反应的诊治水平。方法 :回顾性分析我院在 1993年 12月～ 2 0 0 0年 12月完成的 5 6 8例肾移植中发生的 6例超急性排斥反应 ,其中 5例发生于手术过程中 ,1例发生于术后 36h。结果 :6例均行移植肾切除 ,病理证实为超急性排斥反应。其中 2例随即行再次移植 ,1例移植另一供者的肾脏获得成功 ,另 1例移植同一供者的另一肾脏失败。结论 :超急性排斥反应是肾移植的严重并发症 ,预防是最为重要的 ,良好的HLA配型可防止其发生 ,发生超急排斥反应后 。

Objective:To present and evaluate the diagnosis and treatment of 6 cases of hyperacute rejection reaction (HAR) in kidney transplantation.Methods:We reviewed 568 patients of kidney transplantation performed in our hospital from December 1993 to December 2000, 6 cases occurred HAR(1.1%),5 cases occurred during operations and 1 case in 36 hours after operation.Results:All the 6 cases were performed nephrectomy and confirmed by pathology.Two cases received the second transplantation in one operation, 1 case was cured by transplanting a kidney of other donor, however, another case failed in transplanting a kidney of the same donor.Conclusions:HAR is a serious complication in kidney transplantation.Prevention is most important, well-matched HLA-antigen will eliminate the occurrence of HAR. It may succeed if we try to perform the second transplantation using other donor's kidney in one operation.