高龄患者肾脏移植51例分析

Study of Renal Transplantation in Aged Uremic Patients

回顾性分析 5 1例年龄大于 60岁的高龄患者 (其中最大者 79岁 )的肾移植资料 ,以研究高龄尿毒症患者肾脏移植的特点。结果 :5 1例患者中 4 7例存活 ,4例死亡 ,1年人、肾存活率分别为 88.2 %和 86.2 %。 2例死于术后急性肾小管坏死合并心衰和肺部感染 ,1例于术后 5月死于重症肺炎 ,1例于术后 1年死于车祸脑出血。术后发生超急性排斥 1例而切肾 ,急性排斥 4例 ,慢性排斥 2例 ,肾小管坏死 4例 ,CsA肝肾中毒 1 3例 ,粒细胞减少症 6例 ,移植后继发糖尿病 2例 ,肺部感染 9例 ,心功能不全 8例 ,输尿管膀胱吻合口瘘 1例。提示 :高龄患者同样适合行肾移植手术 ,强调术前应充分准备 ,控制感染和心脑血管疾病 ,术后护理、免疫抑制剂的应用及监测的及时合理 ,对肾移植成功至关重要 ;

Fifty one uremic patients over 60 who received cadaveric renal transplantation were retrospectively analyzed in order to investigate the renal transplantation in the aged uremic patients. Results: the survival rate of person/kidney one year was 88.2%/86.2%. Two patients died from the acute tubular necrosis and heart failure and lung infection, one patient died from the severe pneumonia while the other one died from cerebrovascular accident. The total complications post transplantation included one hyperacute rejection, four acute rejection, two chronic rejection, four acute tubular necrosis, 13 hepatotoxicity and nephrotoxicity of cyclosporin A, six leukopenia, 2 posttransplant diabetes mellitus, 9 lung infection, eight heart failure and one fistula in the ureterocystanastomosis. Therefore, the advanced patients are still suitable for the renal transplantation. It special attention has to be paid on the treatment of infection and cardiovascular diseases and nursing care, and it is also important to adjust and monitor the toxic side effects of the immunosuppressive drugs, and the dose of CsA in the aged patients should be lower.