活体亲属肾移植19例报告

Living relative donor renal transplantation:Report of 19 cases

目的探讨活体亲属肾移植的临床应用价值。方法回顾性分析我院2002年2月～2006年5月完成的19例活体亲属肾移植的临床效果。结果19例供者术中均未输血,术后未发生严重的并发症,于术后7～10天出院。术后随访1～51个月,平均28个月,复查肝、肾功能均正常。19例受者术后随访1～51个月,平均28个月,其中16例术后3～5天肾功能恢复正常,3例于术后3周内肾功能恢复正常。2例发生急性排斥反应,其中1例经激素冲击治疗后逆转,另1例激素治疗无效,改用抗人血淋巴细胞球蛋白治疗10天后逆转。1例为同卵双生兄弟之间肾移植,术后仅用激素治疗3周,未用其他免疫抑制剂,未发生急性排斥反应。2例术后情况良好,半年后自行减量乃至停用免疫抑制剂,导致急性排斥反应,经激素冲击治疗后好转。1年人/肾存活率为100%。结论活体亲属肾移植安全可行;受者人/肾存活率高。

Objective To summarize the clinical experience of living relative donor kidney transplantation. Methods A retrospective analysis on 19 cases of living relative donor kidney transplantation from February 2002 to May 2006 was carried out. Results No blood transfusion was needed and no serious postoperative complications occurred in donors. The 19 donors were discharged from hospital at 7 - 10 days postoperatively. Follow-up examinations for 1 -51 months （mean, 28 months） in the 19 donors revealed normal liver and renal functions. Among the 19 recipients, follow-up examinations for 1 -51 months （mean, 28 months） showed that the renal functions recovered in 3 - 5 postoperative days in 16 recipients and within 3 weeks after transplantation in 3. Acute rejection occurred in 2 recipients postoperatively, and was reversed by steroid pulse therapy in 1 recipient and by ALG treatment for 10 days in 1 recipient, in whom the hormone pulse therapy was invalid. The hormone treatment was needed for only 3 weeks in a renal transplantation between monozygotic twins, without using other immunosuppressors, and no acute rejection occurred. Two patients with an uneventful recovery developed an acute rejection because of voluntary decrement and even stopping of immunosuppressor after 6 months, and then was treated with hormone pulse treatment until a reversion. The 1-year survival rate for patient/kidney was 100%. Conclusions Living relative donor renal transplantation is safe and feasible, offering a high survival rate for patient/kidney.