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目前同种肾移植的症结所在依然是怎样提高长期存活率和生活质量。由于移植免疫学的迅速发展,同种肾移植近期效果明显提高,移植肾1年存活率超过90％,尸肾移植物半数存活时间(T1/2)亦由原来的6.7年延长至90年代的10.9年,但长期效果还不尽人意。影响长期存活的因素很多,如供肾质量、缺血时间、移植肾功能延迟恢复(GDF)、淋巴毒交叉反应、HLA配型、免疫抑制剂以及急性排斥反应等。近年来,越来越多的证据表明,急性排斥反应是影响移植肾长期存活的重要独立危险因素。
The crux of the same type of kidney transplant is still how to improve long-term survival and quality of life. Due to the rapid development of transplantation immunology, the immediate effect of allogeneic kidney transplantation was significantly improved. The one-year survival rate of graft kidney exceeded 90% and the median survival time of carcass and kidney graft (T1 / 2) from 6.7 to 90 years 10.9 years, but the long-term effect is not satisfactory. Many factors affect the long-term survival, such as kidney mass, ischemic time, delayed graft function recovery (GDF), lymphoid cross-reactivity, HLA matching, immunosuppressive agents and acute rejection. In recent years, more and more evidences show that acute rejection is an important independent risk factor for long-term graft survival.