亲属活体供肾与尸体供肾肾移植临床疗效的比较

The Clinical Comparison of Living Related and Cadaveric Donor Kidney Transplantation

目的回顾总结同期完成的活体亲属供肾移植及尸体供肾移植51例的临床经验,分析不同肾脏来源的肾脏移植术后疗效,为开展活体亲属供肾移植提供科学依据.方法收集2002年2月至2008年6月在我院接受活体亲属供肾移植的51例受者、接受尸体供肾移植31例受者的临床资料,对不同肾脏来源受者的性别、年龄、HLA位点配型、手术情况、术中和术后近、远期并发症、免疫抑制方案、肾功能恢复情况及长期随访资料进行对照研究,进一步明确活体亲属供肾移植的临床意义.结果51例活体亲属供肾移植手术均获成功,其中1例术后7个月因骨髓抑制、重症感染自动出院后死亡.人/肾1a存活率为98.07%;尸体供肾移植手术成功,1例因术后5月多囊肾破裂大出血死亡,3例在术后1a内因重症肺部感染死亡,人/肾1a存活率87.10%.结论2种不同来源的肾脏移植在并发症以及人/肾1a存活率等指标上亲属活体供肾移植优于尸体供肾移植.活体亲属供肾移植术前准备充分,配型好,术后并发症少,人/肾存活率高,肾脏来源较为广泛,为肾脏衰竭患者提供了可靠的治疗手段.

Objective By reviewing clinical experience of the living related donor kidney transplantation and at the same period in hospital, and analyzing the effect of different sources of kidney transplantion, to provide a scientific basis for developing live related donor kidney transplantation. Methods We collected 51 cases of living related donor kidney transplantation in February 2002 - June 2008 in the hospital, accepted 31 cases＇ clinical data of cadaveric donor kidney transplantation, studied comparatively the different kidney sources of the gender, age, HLA-matching point, surgery, during and after the operation, long-term complications, immune suppression using, kidney function and long-term follow-up data, to clear the clinical significance of living-related donor kidney transplantation. Results 51 cases of living-related donor kidney transplant ation were successful, of which one case died of marrow suppression and severe infection after seven months. The l-year patient/graft survival rate was 98.07%. Cadaveric donor kidney transplantation were successful, of which one case died of polycystic kidney disease, three cases died of severe lung infection after one year, The 1-year patient/graft survival rate was 87.10 %. Conclusions The living related donor kidney tronaplantion is superior to the cadaveric donor kidney transplantation on complications and 1-year patient/graft survival rate and other factors. It provides a reliable means of treatment for patients for full preparation, good matching, fewer postoperative complications, higher patient/graft survival rate, and wider source of kidneys.