同种异体双肾移植8例报告

Dual transplantation of adult kidneys——8 cases report

目的 :利用部分“边缘肾” ,或因血型特殊局部地区无适合受体的供肾进行双肾移植 ,探讨双肾移植的临床疗效。 方法 :自 2 0 0 1年 3月至 2 0 0 2年 1 0月 ,我们共利用该类“边缘肾”与“无人要的肾脏”为 8例患者进行了双肾移植。采用右下腹“L”型切口 ,来自 8个供体的 1 6个肾脏被分别移植于 8例受者的右侧髂窝内。免疫抑制方案为皮质激素 +霉酚酸酯 +环孢素A ,剂量同单肾移植。 结果 :在 1～ 1 2个月的随访期内发生急性排斥(AR) 2例共 2次 (2 5 % ) ,1只肾由于肾动脉栓塞失功。 5例随访 1 2个月肾功能均正常。 结论 :双边缘肾移植有助于充分利用日趋紧张的肾源 ,提供给患者更多的有效肾单位。肾移植的免疫抑制方案 ,AR发生率 。

Objective:Since short of donor, 'Marginal kidneys', the low quality donor kidneys have been used for dual kidney transplantation abroad. However, in our country, in one hand we have the same situation of donor shortage. On the other hand, some donor kidneys have to be given up since small volume, blood vessel injury and nobody wanted in the local area owing special blood type. Methodology:Eight cases performed dual kidney transplantation by using 'marginal kidneys' and 'nobody wanted kidneys' were analyzed. Both donor kidneys were placed into right iliac fossa by 'L' incision for one adult recipient. The immunosuppressive regime was same as single kidney transplantation: steroid, CsA and MMF. The dosage is as same as single renal transplantation. Results:Two cases had one episode of acute rejection, respectively (25%). One was renal dysfunction because of renal artery embolism. Except those patients, five case were normal renal functions during follow up period. Conclusion:Dual kidney transplantation by using 'marginal kidneys' and 'nobody wanted kidneys' will adequately utilize demanded donor resource and effort more effective renal units. The immunosuppressive regimen and acute rejection episode are the same as single kidney transplantation.