活体肾移植25例临床分析

Living-donor kidney transplantation(25 cases reports)

目的总结我院25例亲属活体肾移植的临床效果和经验。方法25例亲属活体肾移植,6例非血缘亲属供肾包括5例夫妻和1例岳母供肾,血缘亲属供肾包括15例父母和4例同胞供肾,供体均开放手术取肾,肾脏按常规植于左侧或右侧髂窝,术后采用FK506+MMF+Pred或CsA+MMF+Pred三联免疫抑制治疗,观察术后早期肾功能恢复情况和长期移植肾功能。结果25例供者术后均顺利恢复,无严重并发症,住院日5～12d,平均9.3d,术后肾功能均在正常范围,均恢复正常生活。受者术后均恢复正常肾功能,住院日10～35d,平均13d。8例术后出现急性排斥反应,发生率为32%,均治愈。结论活体亲属肾移植扩大了肾脏来源,供肾冷、热缺血时间短,移植后恢复迅速,远期效果好,是治疗终末期肾病的有效手段,能有效解决供体短缺的问题。

Objective To determine outcome after living-donor kidney transplantation in our center.Methods From December 2005 to July 2007,a total of 25 living-donor kidney transplantations were performed in our hospital. The donors include parents （n=15）, sib- lings （n=4）, spouses （n=5）, and mother-in-law （n=l）. The surgical technique of living kidney donation involved nephreetomy via an open extraperitoneal approach in all patients.Kidney transplantation was performed on the recipients＇fight or left side routinely.Results The average hospital stay after living-donor nephreetomy was 9.3 days （ranged 5- 12 days） whereas recipients were discharged on POD 13 （ranged 10- 35 days）. All the receptors recovered well from the operation and got well renal function.Acute rejection occurred in 32% of the recipients.Conclusion Living-donor kidney transplantation is a highly effective therapy for patient with end stage renal failure, and it can help to resolve the puzzledom of donor-shortage.