肾移植术后移植肾功能延迟恢复的原因

The causes of delayed graft function post-kidney transplantation

目的探讨肾移植术后移植肾功能延迟恢复(DGF)发生的原因及处理方法。方法回顾性总结97例肾移植术后DGF患者的临床资料。结果发生DGF的病因包括急性排斥反应45例(46.4%),急性肾小管坏死39例(40.2%),环孢素A中毒7例(7.2%),髂静脉血栓3例(3.1%),输尿管梗阻3例(3.1%)。76例DGF经治疗后移植肾功能恢复正常,19例血肌酐稳定在200μmol/L左右,1例因应用抗淋巴细胞球蛋白后并发肺部感染死亡,1例应用甲基强的松龙冲击治疗后移植肾功能未好转而恢复血液透析治疗。结论急性排斥反应及急性肾小管坏死是引起肾移植术后DGF的最主要因素。

Objective To investigate the cause and treatment of delayed graft function （DGF） in venal transplant recipient. Methods From January 2000 to December 2005 in the first hospital of Jilin university, the clinical data on the causes and the treatments of renal transplant recipients with delayed graft function were retrospectively analysed. Results In the 97 patients with DGF,the causes were acute rejection episode in 45 cases（46. 4% ） ,acute renal tubular necrosis in 39 cases（40. 2% ） ,acute cyclosporine Anephrotoxicety in 7 cases（7.2% ） ,iliac venous thrombosis in 3 cases （3. 1% ） , and ureteral obstruction in 3 cases （3. 1% ）. The renal function became normal in 76 patients;serum creatinine （Scr） returned to 200 μmol/L or so in 19 cases;there was one case died of pulmonary infection after using antilymphocyte globulin （ALG） while one case resumed dialysis with failure to Methylprednisolone（MP） treatment. Conclusions Acute rejection and acute renal tubular necrosis were the main reasons for DGF.