老年患者肾移植的临床经验

Clinic experience of kidney transplantation in aged patients

目的 探讨高龄患者肾移植手术的适应证、免疫抑制剂的应用和对急性排斥的免疫监测及其他并发症的防治。方法 对 64例 60～71岁尿毒症患者进行尸体肾移植手术 ,术后进行移植肾脏功能、T细胞亚群、ICAM 1等指标监测。结果 1年人 /肾存活率为 92 .6 % / 83 .9% ,3年为 85 .2 % / 74.1 % ,5年为 82 .4% / 72 .2 %。急性排斥发生率为 2 7%。结论 合理应用免疫抑制剂及监测和治疗急性排斥反应 。

Objective To study the application indications of operation, the applications of immunosuppressants, the monitoring effect of T-cell subgroups, ICAM-1 for acute rejections and the prevention and therapy of postoperative complications of the renal transplantation in aged patients. Methods Sixty-four patients (60～71 years old) with uremia received cadaveric renal transplantation in our hospital.Results The survival rate of patient/kidney was 92.6%/83.9% for one year, 85.2%/74.1% for three years and 82.4%/72.2% for five years. The acute rejections occurred in 27 of patients.Conclusions The important factors to increase the survival rate of renal transplantation in old patients with uremia include the proper application of immunosuppressants, monitoring and therapy of acute rejection and prevention of postoperative complications.