抗肾内动脉痉挛在肾移植术中供肾不明原因缺血时的应用

Application of anti intrarenal artery spasm in renal allografts with unknown ischemia during kidney transplantation

目的 探讨抗肾内动脉痉挛 (IRAS)在肾移植术中供肾不明原因缺血时的应用价值。方法 回顾性分析抗IRAS在 3 1例肾移植术中供肾不明原因缺血时应用的效果。结果 2 9例肾缺血完全消失 ,证实缺血由IRAS引起 ,术后肾功能完全恢复正常 ,其中 2 3例已随访 1年以上 ,移植肾 1、2、3、4年有功能存活率分别为 91.3 %、78.3 %、65 .2 %、65 .2 % ;治疗无效切除肾脏 2例 ,术后病理检查证实为超急性排斥。结论 在肾移植术中供肾出现不明原因缺血时采用抗IRAS措施 ,对其中的IRAS病例具有诊断和治疗的双重意义。

Objective To explore the value of application of anti intrarenal artery spasm (IRAS) in renal allografts with unknown ischemia during kidney transplantation. Methods The effects of anti IRAS measures were analyzed retrospectively in 31 cases of renal allograft with unknown ischemia during kidney transplantation. All of 31 patients were followed and 23 were over 1 year. Results Ischemia disappeared in 29 cases in which the cause was confirmed to be IRAS and their renal function was restored with no acute tubular necrosis. Among the 23 cases of over 1 year follow up, the 1 , 2 , 3 and 4 year functional survival rate was 91.3%, 78.3%, 65.2% and 65.2% respectively. Two allografts were excised because of hyperacute rejection. Conclusion Anti IRAS is essential for those with unknown renal ischemia during kidney transplantation, especially for those having IRAS during the operation for their diagnosis and treatment.