高龄活体亲属供肾移植14例临床分析  

Elder living related donor kidney transplantation:clinical analysis of 14 cases

作　　者：王继纳[1] 程宙[1] 许明[1] 戎瑞明[1] 王国民[1] 朱同玉[1] 

机构地区：[1]复旦大学附属中山医院泌尿外科,上海200032

出　　处：《复旦学报（医学版）》2008年第6期829-831,845,共4页Fudan University Journal of Medical Sciences

基　　金：上海市自然科学基金项目(074119634)

摘　　要：目的比较高龄活体亲属供肾移植与标准活体亲属供肾移植的临床效果。方法回顾性分析高龄活体亲属供肾移植14例、标准活体亲属供肾移植84例的临床资料,并对供/受体进行回访,比较两组供肾移植术后供/受体的肾功能恢复情况及移植肾功能恢复延迟发生率、急性排斥反应发生率、存活率。结果高龄供体及标准供体间手术前后肾功能的变化量无显著差异(P>0.05);移植肾功能恢复正常时间在高龄供肾组为(4.2±2.1)d,在标准供肾组为(3.3±1.6)d,两组间无显著差异(P>0.05);高龄供肾组和标准供肾组移植肾急性排斥反应发生率分别为14.3%和9.8%,移植肾功能恢复延迟发生率分别为21.4%和11.0%,移植肾存活率分别为92.9%和98.8%。结论术前对高龄供体进行严格筛选及全面综合评估,高龄活体亲属供肾移植同样也是安全有效的。Objective To analyze the difference in clinical outcome between elder living related donor kidney transplantation （ELRDKT） and standard living related donor kidney transplantation （SLRDKT）. Methods The clinical data of 14 ELRDKTs and 84 SLRDKTs retrospectively, both donors and recipients were followed up. The comparison between were analyzed ELRDKT and SLRDKT was made on renal function of donors/recipients, the rate of delayed graft function （DGF） and acute rejection （AR）, and the survival rate of renal graft. Results There was no significant difference in the change of serum creatinine （Set） between elder donors and standard donors （P〉 0.05）. There was no significant difference between ELRDKT and SLRDKT in the recovery time [-（4.2 ± 2.1） vs （3.3 ± 1.6）days,P〉0. 051 while the Scr returned to normal. In groups of ELRDKT and SLRDKT,the rate of AR was respectively 14.3% and 9.8% ,the rate of DGF was respectively 21.4% and 11.0% ,the survival rate of renal graft was respectively 92.9% and 98.8%. Conclusions With stringent screening and overall assessment of elder donors, ELRDKT is safe and effective for patient with end-stage renal disease procedure.

关 键 词：肾移植 活体亲属供体 高龄供体 

分 类 号：R617[医药卫生—外科学]