55岁以上活体供肾移植中供受者肾功能的恢复特点

Recovery characteristic of donor＇s and receptor＇s renal function from age over 55 years living donors donate kidneys

目的探讨使用年龄≥55岁的活体供肾肾移植的临床特点、疗效及安全性。方法对北京朝阳医院近年完成的19例供者年龄在55岁以上的活体供肾肾移植手术进行回顾性研究。19例供者平均年龄58岁，肌酐清除率（Ccr）平均（81．7±2．2）ml／min；19例受者平均年龄34岁，血液透析时间平均4个月。移植肾术中常规0点穿刺行组织学检查。结果全部供者均平稳度过围手术期，未发生任何手术并发症，血肌酐术后1周均在正常范围内。术后1年血肌酐和Ccr分别与术后1周和6个月时比较差异无统计学意义。血压和血糖无明显变化，尿蛋白（-）。所有受者肾功能早期恢复，无移植物功能延迟恢复（DGF）发生。7例接受Ccr低于80ml／min供者肾源的受者术后血肌酐下降相对缓慢。在19例供肾中，3例。肾小球硬化超过10％。结论肾源紧缺是目前制约肾移植发展的重要因素，放宽对活体供者年龄的限制无疑会扩大。肾源，挽救更多尿毒症患者；高龄供者的活体肾移植是安全可行的。

Objective To observe and research clinical characteristics and curative effect and safety of renal transplantation from living elderly donors donating kidneys. Methods Retrospective study on the 19 living kidney donors who were over 55 years old and on the renal transplantation operations completed by our center for the past few years. Among the 19 donors, with an average age of 58 years old. Their mean creatinine clearance was 81.7 ± 2.2 ml/min. Among the 19 acceptors, with an average age of 34 years old. All kidney before the open circulation transplant performed routine 0 point puncture and histological examination. Results All donors smoothly spent their perioperative period without any surgical complications. All the donors keep their blood Cr in a normal range one week after the operation. There was no significant difference between posttransplantation one week and six month and one year in blood Cr and Ccr. Blood pressure and blood sugar didn＇t not have significant changes, urine.protein （ - ）. All receptors＇ renal functions recovered in early stages without DGF. 7 receptors who had Ccr lower than 80 ml/min had their blood Cr decreased slowly. Among the 19 kidneys donated, 3 donors＇ glomerulosclerosises were higer than 10 percent. Conclusions The kidney source shortage is the main factor that restricts the development of the renal transplantation currently, undoubtedly, the application of elderly donors will expand the kidney source and save more uremic patients. Renal transplantation is safe and feasible with the help of living elderly donors.