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目的 :探讨活体亲属供肾移植的意义和围手术期处理。 方法 :回顾分析 11例亲属供肾移植临床资料。 结果 :11名供者分别为受者的父母、兄弟和妹妹 ,取左侧肾脏 10例 ,右侧肾脏 1例 ,取肾术历时 2～ 3 5h ,热缺血时间 1～ 3min ,所有供者术中、术后均未发生严重并发症 ,仅 3例供者术后 3周内出现一过性蛋白尿。 11例受者均为首次移植 ,肾脏植入顺利 ,肾功能恢复良好 ,术后早期发生急性排斥反应 2例 ,经甲基强的松龙冲击治疗后逆转。受者 1年人 /肾存活率为 10 0 % / 10 0 % ,1例于术后 1 5年死于肝功能衰竭 ,死亡时移植肾功能正常。 结论 :选择供者的主要内容是确定组织相容性是否适合和供者双肾形态及功能是否正常。活体取肾手术难度较高 ,对大部分供者来说 ,切取左侧肾脏较好。活体供肾移植的存活率明显高于尸体肾移植 ,应提倡活体亲属供肾。
Objective: To explore the significance of perinatal renal transplantation and perioperative management. Methods: Retrospective analysis of 11 cases of relatives for kidney transplantation clinical data. Results: The 11 donors were the recipients’ parents, brothers and sisters respectively. Ten cases of the left kidney and one case of the right kidneys were selected. The kidney lasted for 2 ~ 35 hours and the warm ischemia time was 1 ~ 3 minutes. All the donors There were no serious complications during and after surgery. Only three patients had transient proteinuria within 3 weeks after operation. Eleven recipients were all transplanted for the first time. The kidneys were implanted successfully and the renal function recovered well. Two cases of acute rejection occurred in the early postoperative period and were reversed after the treatment with methylprednisolone. The 1-year survival rate of the recipients was 100% / 100%. One patient died of liver failure 15 years after the operation and had normal renal function at the time of death. CONCLUSIONS: The mainstay of choice for donors is to determine if tissue compatibility is appropriate and whether donor kidney morphology and function are normal. In vivo surgery more difficult kidney surgery, for most donors, cut the left kidney better. Survival of living donor kidney transplantation was significantly higher than that of cadaver kidney transplantation, living relatives should be advocated for kidney.