二次肾移植的效果及影响因素

Analysis of Effective Factors on Second Kidney Transplantation

【目的】探讨二次肾移植的效果及其相关影响因素。【方法】回顾分析46例二次肾移植病例,对二次移植的效果及切除与保留失功肾、距首次移植的时间对二次移植的影响进行分析。【结果】二次肾移植与首次移植的1、3、5年病人存活率方面无明显差异,但3、5年移植肾存活率明显下降,二次移植排斥反应发生率明显上升,以慢排为主;保留和切除失功肾及距首次移植时间对二次移植人/肾存活率及排斥反应均无明显影响。【结论】二次移植仍是移植肾失功后的首选治疗措施,其急排和慢排发生率较首次移植明显升高。失功肾的保留及距首次移植时间对排斥反应及人/肾存活率无明显影响。

[Objective]To study the effective factors on second kidney transplant.[Methods]Forty six cases of second kidney transplantation were retrospectively analyzed.The survival rate in allografts and recipients between second transplant and primary transplant and between grafts removal and retention was compared and analyzed.[Results]The survival rates of recipients were similar in second and primary transplant,but the regraft survival rates in 3 and 5 years were poorer in second transplant significantly.The acute and chronic rejection in second transplant increased obviously,but not in super-rejection.No significant difference was seen in recipients/ regrafts survival rate and rejection between grafts removal and retention groups.[Conclusion]Second kidney transplantation is the optimal therapy after first graft failure.Rate of acute and chronic rejection is higher than first transplantation.Graft removal or retention and the duration between the first and the second kidney transplantation have little contribution for recipients/ regrafts survival rate and rejection.