亲属活体肾移植112例临床分析  

Clinical Analysis of Living-related Donor Kidney Transplantation

作　　者：郭冠飞[1] 许长宝[1] 赵兴华[1] 

机构地区：[1]郑州大学第二附属医院泌尿外科,郑州市450003

出　　处：《医药论坛杂志》2009年第7期35-37,共3页Journal of Medical Forum

摘　　要：目的总结分析112例亲属活体肾移植的经验。方法回顾性分析112例已完成的活体亲属供肾肾移植患者的，临床资料，11例为夫妻间供肾，其余为血缘亲属供肾；交叉反应组（CREGs）误配率为3MM（miss match）、2MM、1MM、0MM的移植例数分别为74，11，4，23；112例均为开放手术取肾，32例取供者右肾，80例取左肾；受者均为第一次接受肾移植手术，术后采用环孢素A（或他克莫司）、霉酚酸酯及泼尼松三联抗排斥反应治疗。结果所有供者手术顺利，术后7～12天出院，平均9．5天。随访至今，肾功能均正常。所有受者均安全度过围手术期．术后1例发生髂外动脉夹层动脉瘤，1例发生移植肾输尿管梗阻，1例发生淋巴囊肿，均经手术治愈、11例发生急性排斥反应，经抗胸腺细胞球蛋白（ATG）；中击治疗，均逆转。随访2～48个月，人／肾存活率100％／100％结论术前对供、受者进行全面综合评估是亲属活体肾移植成功的保证；亲属活体肾移植等待时间短，组织配型好，供肾缺血时间短，排斥反应发生少，移植肾存活率高。Objective To introduce one -center experience on 112 cases living -related donor kidney transplantation in the past four years. Methods A retrospective analysis on 112 cases of living relative donor kidney transplantation from Febrnary 2004 to September 2008 . 11 cases were donated by spouse, the others were donated by blood relationship donors. According to the rule of Human leukocyte antigen （HLA）matching,the cases of patients with miss match（MM）sites numbers of 0 to 1,2 and 3 were 23,4, 11and 74 respectively, All living donor underwent successful open extraperitoneal nephrectomy , in which 32 cases donated right kidneys and 80 cases donated left kidneys. All the recipients underwent their first kidney transplantation. Triple- combined immunosuppressive protocols consisted of Cyclosporin A（ CsA）/ Tacrolimus（FKS06） ,Mycophenolate mofetil（MMF）and steroi. Results All donors were discharged in 7 12 days postoperation, mean days was 9. 5 days. Follow - up of these cases has varied from two months to four years, the donors kept normal kidney function . Acute rejection（AR） episodes occurred in 11 patients postoperatively, and were reversed successfully by Antithymocyte globulin （ATG）, Surgical complications appeared in 3 patients, 1 case of urinary obstruction ; 1 case of external iliac artery aneurysm ; 1 case of lymphocele ,All were cured by operation. ？dl patients＇ kidneys functioned well up to now. Conclusion Both ethics dilenunas and accurate pre -operation assessment of the donor and recipient are critical for the success. Less waiting time, optimal HLA matches and less isehemia time may result in low incidence of acute reaction, as well as long survival of kidney grits, it is a safe treatment.

关 键 词：肾移植 活体供者 亲属 

分 类 号：R692[医药卫生—泌尿科学]