高危肾病患者的肾移植(附5例报告)

Kidney transplantation in the high-risk recipients(Report of 5 cases)

目的 :探讨高危险性终末期肾病患者的肾移植。方法 :回顾性分析 5例高危险性肾病患者肾移植的临床资料 ,并结合文献复习讨论。结果 :1例肾移植术后 9年患右肾癌患者行右肾癌根治术 ,术后随访肿瘤未复发及转移 ,肾癌根治术后 2年 ,移植肾失功能 ,再次行肾移植 ;2例因尿路梗阻致尿毒症 ,经去除感染病灶等术前准备后再行肾移植 ;另 2例高龄 (>70岁 )尿毒症患者肾移植 ,1例失败 ,1例成功。结论 :高危险性肾病患者经充分术前准备可行肾移植并取得满意效果 ,但对高龄大于 70岁患者应慎重行肾移植术。

Objective:To investigate the clinical features of kidney transplantation in the high-risk patients.Method:A retrospective study was made on the clinical data of 5 cases of the high-risk recipients.Result:After 9 years receiving renal allograft, one case of patient suffered from renal carcinoma and accepted operation. Metastasis had not been found for tow years of follow-up. The second kidney transplantation was successfully performed because of the bad function of the allograft with chronic rejection. The renal transplantation was performed in two 2 cases of patients suffering from obstructive nephropathy. In 2 cases over 70 receiving the renal allografts, one was success and the other not.Conclusion:Satisfactory result could be obtained in the high-risk patients undergoing kidney transplantation if rational preparation was conducted before the operation, nevertheless, the renal transplantation should be carefully considered in the senior receiver, especially more than 70 years old.