移植肾功能延迟恢复的临床研究

Clinical investigation of delayed graft function recovery following renal transplantation

目的探讨肾移植术后移植肾功能延迟恢复(DGF)的病因及诊治方法。方法回顾性分析15例肾移植术后DGF患者的临床资料及诊治过程。15例DGF的病因不同,在血液透析的基础上,分别给予急性排斥反应冲击治疗、调整免疫抑制剂、近期移植肾切除后再次原位移植等方法进行治疗。结果15例患者术后发生急性排斥8例;急性肾小管坏死5例;移植肾静脉血栓1例;环孢素A肾毒性1例,所有患者经治疗肾功能在术后10～35d恢复正常,随访0.5～3年,无并发症发生。结论DGF是肾移植术后常见并发症之一,主要原因是急性排斥和急性肾小管坏死,区别不同原因采用相应治疗,可获得满意疗效。

Objective To investigate the etiology and therapy of delayed graft function （DGF） recovery in renal transplant recipients. Methods The clinical data were retrospectively analyzed in 15 renal recipients with DGF. All the 15 patients received hemodialysis along with pulse treatment against acute rejection （AR）, or immunosuppressant adjustment, or in situ retransplantation after the resection of the original transplanted kidney according to different etiological factors. Results Among the 15 patients, 8 developed AR, 5 showed acute renal tubular necrosis （ATN）, 1 had grafting-associated renal vein embolism and I had acute cyclosporine nephrotoxication. The renal function recovered within 10 to 35 days after transplantation without complication during the follow-up period （0.5-3.0 years）. Conclusion DGF is a common complication after kidney transplantation mainly due to the occurrence of AR and ATN. Good prognosis is expected if etiology-oriented therapy is performed properly and promptly.