活体亲属肾移植68例临床报告

68 cases of living-related donor kidney transplantation

目的总结分析68例亲属活体肾移植的经验。方法对68例活体亲属肾移植供受体的术前准备、取肾方式及术后用药、恢复情况进行观察及随访。结果 68例亲属供者术后均恢复良好,随访1月～6年无手术并发症及肾功能异常改变。60例受者于术后1～3d血肌酐降至正常水平,15～22d痊愈出院;3例移植肾丧失功能,恢复血透;2例因术后发生急性排斥反应出现肾功能恢复延迟(DGF);2例分别于术后3月和6月因肺部感染放弃治疗死亡。结论术前对供、受者进行全面综合评估是亲属活体肾移植成功的保证,亲属活体肾移植等待时间短,组织配型好,供肾缺血时间短,排斥反应发生少,移植肾存活率高,是一种相对安全可行的治疗手段。但该手术仍是一种高风险手术,应慎重对待。

[Objective] To introduce the experience on living-related donor kidney transplantation（LDKT）.[Methods] 68 patients underwent LDKT.The preoperative preparation,methods to donor＇s nephrectomy,postoperation medication and comeback condition were summarized.[Results] All donors comebacked favourable and had not operative complication and abnormity of kidney function after follow-up 1month to 6 years;The blood creatinine reduced to normal in 1~3 days postoperation and were discharged in 15~22 days in 60 recipients,graft loss occurred in 3 cases and come back to hemodialysis,delayed graft function（DGF） occurred in 2 cases because of acute rejection,2 patients died after 3 and 6 months because of lung infection but abandoning treatment.[Conclusions] Both overall and accurate preoperation assessment of the donor and recipient are critical for the success.Optimal HLA matches and less ischemia time may result in low incidence of DGF and acute rejection,as well as long survival of kidney grafts.It is still a treatment method that safety comparatively but high-stake operation.