高龄活体供肾移植临床研究

Study on elder living related donor kidney transplantation

目的探讨高龄活体供肾移植的安全性及临床效果。方法回顾性分析高龄活体供肾移植(60岁<供体年龄≤65岁)11例供体(A1组)、受体(A2组)临床资料,与同期开展的其他96例适龄活体供肾移植(供体年龄<60岁)供体(B1组)术后1、3、6、12月血压和24H尿蛋白定量情况及受体(B2组)在术后1、3、6、12月移植肾功能状态进行比对分析。结果术后6、12月A2组与B2组移植肾存活率分别为100%和90.9%、98.9%和95.8%,组间差异无统计学意义(P>0.05);B2组术后1、3、6、12月血肌酐指标同A2组间差异均无统计学意义(P>0.05);A1组术后1月24H尿蛋白定量和收缩压指标均较A2组增高,差异有统计学意义(P<0.05);术后3、6、12月尿蛋白定量和术后6、12月收缩压值在A1、A2组间差异均无统计学(P>0.05)。结论术前严格评价、术中仔细操作、术后完善随访是保证高龄活体供肾移植成功的关键,可以收到安全、有效的临床效果。

Objective To investigate the safety of elder living related donor kidney transplantation.Methods The clinical data of 11 cases of elder living related donor kidney transplantation were analyzed retrospectively,while the donors were named group A1 and the recipients were named group A2.Meanwhile,the other 96 cases of donor related kidney transplantation were enrolled as controls,while the donors were named group B1 and the recipients were named group B2.The comparison between group A and group B were studied on serum creatinine（Scr） of allografts,changes of blood pressure and urine protein of donors post transplantation.Results There were no difference had been found on survival rate and Scr level of grafts between group A2 and B2（P0.05）.While,statistic difference had been found on the levels of systolic pressure and urine protein between group A1 and B1 1 month post transplantation（P0.05）.Conclusions Elder Living related kidney transplantation provides safe and effective Results on recipients and grafts survival with little impacts on donors.Simultaneously,we should think cautiously of the physical evaluation before operation and the follow-up post operation.