60岁以上尿毒症患者肾移植的临床观察

Cadaveric renal transplantation in urenda Patients more than 60 years of age

目的：探讨高龄尿毒症患者尸体肾移植手术的适应证、免疫抑制剂的应用和T细胞亚群、ICAM—1对急性排斥的监测治疗及并发症的防治。方法：对37例60～71岁尿毒症患者进行尸体肾移植手术，术后进行各项指标监测。结果：1年人／肾存活率为83．8％／75．7％；3年为78．6％／67．9％，5年为72．2％／55．6％。急性排斥发生率为24．3％。结论：合理应用免疫抑制剂及监测和治疗急性排斥反应，降低术后并发症是提高高龄患者肾移植存活率的重要因素。

Objective: To study the indications of operation, the applications of immunosuppressants, themonitoring effect of T-cell subgroups,ICAM-1 for acute rejections and the prevention and therapy of Postoperative comolcations of the cadaveric renal transplantation in patients aged over 60 years with ureemia. Metheds:Thirty-seven Patients aged over 60 year with uremia received cadaveric renal transplantation in our hospitalfrom July 1978 to July 1996. Results :The survival rate of Patient /kidney was 83. 8 %/75. 7% for one year, 78.6%/67. 9% for three years and 72. 2%/55. 6% for five yeals. The acute rejections occurred in 24. 3% of Patients. The common complications were infections cardiovascular complications and the toxic side effect of immunosuppressants. The mortality of this group was higher than that in low risk group of renal transplantation.Conclusion:The important factors to increase the survival rate of renal transplantation in urenda Patients agedmore than 60 include the proper aPPlication of immunosuppressants, monitoring and therapy of acute rejectionand prevention of postoperative complications,etc.