活体肾移植术对供受者的影响

The impact on the donors and the recipients of the live donor renal transplantation

目的 评价活体肾移植术对供受者健康的影响。方法 对 6组活体肾移植术供受者进行随访 ,动态观察供受者术后并发症及肾功能情况。结果 6名供者 ,肾切除术后无并发症 ,术后肾功能正常。 6名受者 ,其中 1名PRA10 0 % ,但患者和家属坚决要求手术 ,尸体肾移植术失败后再行活体肾移植术后发生超排 ,维持性透析状态。 5名均予三联免疫抑制治疗 ,术后无其他不良并发症 ,肾功能均恢复至正常范围 ,其中 1名术后发生急性排异 ,予甲基强的松龙 (MP)冲击及抗淋巴细胞球蛋白 (ATG)治疗后肾功能恢复正常 ,另 1名发生临界排异 ,予MP冲击 5天缓解。结论 活体肾移植术效果肯定 ,可延长受者及移植物存活时间 ,对供者健康影响较小 ,可以在有一定条件的单位开展 ,并应重视对供受双方的术前健康评价和术后随访。

Objective To assess the physical impact on the donors and recipients of the live related renal transplantation.Methods Six live donor renal transplantations were taken from Jan.2000 to Dec.2002 and the donors and recipients were all followed up.The perioperation complications and the renal functions were dynamically observed.Results Among the 6 recipients,1 case failed in the cadaveric donor renal transplantation occurred the hyperacute rejection this time and continued in the hemodialysis status.5 recipients got the triple immunosuppressive therapy with normal renal functions.1 case occurred the acute rejection and another case occurred subclinical rejection,both recovered after antirejection therapy.No other complications occurred.Conclusion Live related renal transplantation provides significant advantages in terms of improved patients and graft survival with little impacts on donors.We should think highly of the preoperation physical evaluation and the postoperation follow-up.