多囊肾患者肾移植术后的临床效果

Clinical result of renal transplantation in polycystic kidney disease

目的:探讨多囊肾患者肾移植的特点、并发症及其对移植效果的影响。方法:回顾性分析了42例多囊肾患者和80例非多囊肾患者肾移植的临床资料。对两组患者的术后并发症以及1年和5年的人、肾存活率进行比较。同时对多囊肾组术前切除原肾和不切除原肾的患者进行比较。结果:两组患者在术后移植肾功能延迟恢复,急性排斥反应,心脑血管并发症以及肺部感染的发生率上均无显著性差异。多囊肾组患者术后的泌尿系感染的发生率高于对照组(P<0.05)。多囊肾组和对照组患者,1年和5年人存活率分别为95.24%与97.50%和83.81%与88.92%;1年和5年肾存活率分别为90.48%与94.97%和69.55%与66.54%。多囊肾组术前切除原肾和不切除原肾的两组患者间,上述并发症以及人、肾存活率差异均无统计学意义。结论:多囊肾患者接受肾移植是可行的,术后的人肾存活率与对照组比较差异无统计学意义,不切除原病变肾脏能收到满意的移植效果。多囊肾患者肾移植术后易发生泌尿系感染,应积极采取有效的防治措施。

Objective：To study the special characteristics of renal transplanatation in polycystic kidney disease, its postoperative complications and impacts on transplantation results. Methods： In this study, 42 cases of polycystic kidney receiving kidney transplantation （polycystic kidney disease group） and 80 cases of other diseases （control group） were retrospectively analyzed. Postoperative complications and patient/renal 1-year/5-year survival rates after renal transplantation were compared between two groups. Within the polycystic kidney disease group, we compared the patients with bilateral and unilateral nephrectomy to the patients without original kidney being removed for postoperative complications and 1-year/5 year patient/renal survival rates. Results：No significant differences in delay graft function, acute rejection, cardiovascular events and lung infections were found between the two groups （ P 〉0.05）. The ratio of urinary tract infections for patients within the polycystic kidney disgase group was remarkably higher than for those within control group （ P 〈0.05）. Patients 1-year/5-year survival rates in the polycystic kidney disease and control group were respectively 95.24% and 97. 50%, 83.81% and 88.92% ; 1- year/5-year graft survival rate in the polycystic kidney disease and control group were respectively 90. 48% and 94.97%, 69.55 % and 66.54 %. There was no significant difference in the aforementioned postoperative complications and 1-year/5-year patient/renal survival rates between the patients with nephrectomy and the patients without original kidney being removed within the polycystic kidney disease group （ P〉0.05）. Conclusions： It was feasible that the polycystic kidney patients receive renal transplantation. The overall patient and graft survival rates did not differ between the polycystic kidney disease and control groups. The satisfactory clinical results could be ob- tained without removing the original polycystic kidney. We should take effective measures to prevent and control the urinary tract infections because of its high incidence after transplantation.