摘要
目的 :提高多次肾移植的尿毒症患者移植物的存活率 ,探讨其术式、用药特点和人 /肾存活情况。 方法 :回顾性分析 36例二次肾移植和 7例三次肾移植患者再次移植的时间 ,以及是否保留原移植肾 ,是否应用抗体诱导治疗 ,应用不同免疫抑制剂方案和人 /肾存活率等临床资料。 结果 :本组患者急性排斥反应发生率为34 9% (15 / 4 3) ,移植肾功能延迟恢复的发生率为 39 5 % (17/ 4 3) ,1年人 /肾存活率分别为 88 4 % (38/ 4 3) / 81 4 %(35 / 4 3) ,3年人 /肾存活率分别为 78 3% (18/ 2 3) / 6 5 2 % (15 / 2 3)。 结论 :再次肾移植的患者宜切除原移植肾 ,术前最好采用抗体诱导治疗 ,术后宜采用肝毒性较小的免疫抑制剂。多次肾移植的患者移植肾功能延迟恢复的发生率高 ,人 /肾存活率较初次移植的患者低。
Objective:To investigate the effect of surgical methods,immunosuppressive therapy and the survival rate of patients and grafts in patients with multiple renal transplantation Forty-three patients,36 cases with second and 7 cases with third renal transplantation,were investigated in this study.They were 24 males and 19 females,with a mean of 55 years old (31～67)?The clinical data such as whether removing the former grafts,whether using antibody-inducing therapy,the protocol ofimmunosuppression and the survival rates of patients and grafts in these patients were analyzed The rates of acute rejection and delayed graft fuction (DGF) are 34 9%(15/43) and 39 5%(17/43),respectively.One-year survival rate of patient and kidney were 88 4%(38/43) and 81 4%(35/43),respectively.Three-year survival rates of patient and kidney were 78 3%(18/23) and 65 2%(15/23) In patients with retransplantation,the rates of DGF are higher and survival rates of patient and graft are lower due to the worse general conditions.For prolonging the survival rate of patient and graft,it is necessary to remove the former graft,use antibody-inducing therapy before re-transpalntation,and treat with less-hepatoxic drugs.
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
2003年第1期37-40,共4页
Chinese Journal of Nephrology,Dialysis & Transplantation
