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 renal transplantation in patients with high-risk end-stage renal disease. Methods: The clinical data of 5 renal transplant patients with high-risk nephropathy were retrospectively analyzed and reviewed. Results: One patient with right renal cell carcinoma who underwent renal transplantation nine years after renal transplantation underwent radical nephrectomy. Non-recurrence and metastasis were observed after the operation. Two years after radical nephrectomy, renal function was lost and renal transplantation was performed again. Cases of uremia due to urinary tract obstruction, after removal of the lesion and other preoperative preparation before renal transplantation; the other two elderly (> 70 years old) uremia kidney transplantation, 1 case of failure, 1 case of success. CONCLUSIONS: Patients with high-risk nephropathy have adequate preoperative preparation for kidney transplantation and satisfactory results. However, renal transplantation should be performed with caution in elderly patients older than 70 years.