接受同一供体肝肾联合移植与肾移植的临床研究

Clinical study on the combined liver-kidney transplantation and kidney alone transplantation from the same donor

目的探讨肝肾联合移植肝脏对肾脏的保护作用。方法我院移植中心2002年5月至2006年9月间共进行8例肝肾联合移植手术,对此8例患者及接受同一供体对侧供肾8例肾移植患者及移植物存活率、排斥反应发生率进行分析。结果肝肾联合移植患者及移植物存活率为100%,无可证实排斥反应发生。术后8例患者移植肝功能迅速恢复正常,7例移植肾功能迅速恢复正常,1例移植肾发生急性肾小管坏死,于术后第52天肾功能恢复正常。对应8例单纯肾移植患者,发生急性排斥反应1例,予甲基强的松龙冲击治疗及应用抗人T淋巴细胞免疫球蛋白(anti-thymocyte globulin,ATG)后,于术后50 d移植肾功能恢复正常,余7例患者恢复良好,至末次随访肾功能均正常。结论肝肾联合移植肝脏对肾脏有一定的保护作用。

Objective To explore whether simultaneous combined liver-kidney transplantation （LKT） with organs from the same donor coders benefit to the kidney allograft. Methods Between May 2002 and July 2006, 8 simultaneous LKT and 8 kidney alone transplantation （KAT） with contmlateral kidneys from the same donor were performed in our center. The renal grafts function and rejection rate of them were analyzed. Results Survival rate of LKT recipients and allografts was 100%, there were no rejection episodes. All liver grafts had good primary function, 7 renal grafts had good primary function, 1 renal graft function recovered 52 days after transplantatin for acute renal failure. One acute rejection episode occurred in KAT recipients, and recovered 52 days after transplantatin. Conclusion The clinical study indicates an allograft-enhancing effect of liver transplantation on the renal allograft.