32例同种异体尸供肾移植临床分析

Clinical Analysis of 32 Cases of Cadaveric Renal Transplantation

【目的】总结同种异体肾移植术的经验,提高人/肾长期存活率。【方法】总结1999年5月至2005年9月的32例次肾移植经验,分析术前准备、组织配型、供肾质量、手术操作、并发症防治、免疫抑制剂使用等方面对肾移植效果的影响。【结果】1年人/肾存活率100%/97%,其中12例已存活4年以上,无严重并发症。【结论】热缺血和冷缺血时间及缺血再灌注损伤程度是影响术后肾功能恢复和急、慢性排斥反应发生的重要因素。免疫抑制剂的个体化合理应用、积极的术前准备和严密的术后监测,重视术后少见并发症的处理是降低受体死亡率、供肾长期存活、提高生活质量的重要保障。

[Objective]To summarize cadaveric kidney transplantation for improving the long-term survival rate. [Methods]Thirty two cases of cadaveric kidney transplantation from 1999 to 2004 were analyzed retrospectively.[Results]The 1,3 years patient/graft survival rates were 100%/97% ,89%/79% , 12 cases had been living without severe complications for 4 years. [Conclusion]Preservative injury and degree of ischemic reperfusion injury are common causes of influencing renal function and occurrence of reject reaction. The high quality of donor kidneys, reasonable immunosuppressive regimen , prevention and prompt treatment of complications after transplantation of the patients and active peri-operative treament improve long-term survival rate and quality of life.