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目的总结尸体肾移植手术经验,提高肾移植长期存活率。方法回顾分析1986-2003年1210例肾移植患者取肾、手术技术、免疫抑制药应用及手术并发症发生等资料。男773例,女437例,年龄6~75岁。病因主要为慢性肾炎(1047例),1210例淋巴毒细胞试验均<10%,640例行PRA测定,340例HLA-A、B、DR配对。结果1986-1996年免疫抑制剂采用环孢素A(CsA)、泼尼松(Pred)、硫唑嘌呤(Aza),人/肾1、3、5年存活率分别为96%/95%、85%/80%、65%/64%,主要死亡原因为心脑血管疾病(99/205,48%)。1997-2003年免疫抑制剂采用CsA、Pred、骁悉(MMF),人/肾1、3、5年存活率分别为96%/96%、87%/82%、66%/65%,主要死亡原因为感染(14/25,56%)。结论良好的供肾和组织配型,术后合理应用免疫抑制剂,预防和及时治疗并发症是提高人/肾长期存活率的重要保证。
Objective To summarize the experience of cadaveric kidney transplantation and to improve the long-term survival of renal transplantation. Methods A retrospective analysis of 1210 cases of kidney transplantation from 1986 to 2003 in kidney transplantation, surgical techniques, application of immunosuppressive drugs and complications such as surgical complications. There were 773 males and 437 females, aged 6 to 75 years old. The main causes were chronic nephritis (1047 cases), 1210 cases of lymphatic neutrophils <10%, 640 cases of PRA and 340 cases of HLA-A, B and DR. Results The immunosuppressive agents from 1986 to 1996 were treated with cyclosporin A (CsA), prednisone (Pred) and azathioprine (Aza). The 1, 3 and 5 year survival rates were 96% / 95% 85% / 80%, 65% / 64%. The main cause of death was cardiovascular disease (99 / 205,48%). 1997 ~ 2003 immunosuppressive agents using CsA, Pred, MMF, 1, 3, 5 years of human / kidney survival rates were 96% / 96%, 87% / 82%, 66% / 65% The cause of death was infection (14 / 25,56%). Conclusion Good donor kidney and tissue matching, postoperative rational use of immunosuppressive agents, prevention and timely treatment of complications is an important guarantee to improve the long-term survival of human / kidney.