尸肾移植术1501例总结

A report of 1 501 cases of cadaveric renal transplantation

目的 总结尸肾移植１ ５０１ 例的经验。方法 回顾分析１ ５０１例的临床资料， 包括一般资料、供肾的切取、手术技术、免疫抑制剂的应用、并发症的发生情况等。结果 术后共有３９３ 例发生各种并发症， 各种感染共１５０ 例， 急性排斥反应１１７ 例， 占第３ 位的是急性肾小管坏死４１ 例； 有１１例发生超急性排斥反应， 均为１９９７ 年以前的病例； 共死亡３４ 例， 主要死亡原因为巨细胞病毒感染；１９９７ 年以前的人／ 肾１ 年存活率为９２ ％ ／８７％ ，１９９７ 年以后为９８％ ／９６％ 。结论 术后感染是影响受者存活的主要原因； 排斥反应的预防及免疫抑制剂的合理应用应给予足够的重视。

Objective To summarize the experiences of 1 501 cases of cadaveric renal transplantation from Sep. 1989 to July 1999.Methods The clinical data of 1 501 cases were retrospectively analyzed, including general data, the removal of the donor kidney, surgical technique, the use of immunosuppressants and the occurrence of complications, etc..Results Various complications were found in 393 cases after transplantation, various infection in 150 cases, acute rejection in 117 cases and acute renal tubular necrosis in 41 cases and hyperacute rejection in 11 cases. 34 cases were dead with the main causes being cytomegalovirus infection. The one year survival rate of patient/kidney was 92%/87% before 1997 and 98%/96% after 1997, respectively. Conclusions Postoperative infection was the main cause influencing the survival of the recipients. Much attention should be paid to the prevention of rejection and reasonable use of immunosuppressants.