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目的 :探讨老年患者肾移植手术适应证及术后免疫抑制剂的应用特点 ,提高人 /肾存活率。 方法 :对 5 1例年龄为 6 0～ 83岁的老年肾移植患者进行临床分析 ,研究手术成功与失败者的经验与教训 ,探讨供肾者的质量 ,PRA、HLA配型 ,术后免疫抑制剂应用情况。 结果 :5 1例患者术后发生并发症 2 0例 (39 2 % ) ,其中 ,急性肾小管坏死 3例 ,急性排斥反应 6例 ,CsA肝、肾中毒 2例 ,肺部感染 5例 ,心力衰竭 3例 ,脑出血 1例。 1、3、5年人存活分别为 47、45、42例 ;肾存活分别为 46、44、41例 ,人 /肾 1、3、5年存活率分别为 92 2 % / 90 2 % ,88 2 % / 86 3% ,82 4% /80 4%。 结论 :①良好的组织配型和保证供肾的质量是老年人肾移植成功的第一步 ;②针对老年患者的特点做好围手术期各项工作 ,采取相应措施对老年患者行肾移植可取得满意效果 ;③合理应用免疫抑制剂是提高移植效果的重要保证。
Objective: To investigate the indications of renal transplantation in elderly patients and the application characteristics of postoperative immunosuppressive agents to improve the survival rate of human / kidney. Methods: A total of 51 elderly renal transplant recipients aged 60 to 83 years were enrolled in this study. The experiences and lessons of successful and unsuccessful patients were studied. The quality of donor, PRA, HLA typing, postoperative immunosuppression Agent application. Results: There were 20 cases (39.2%) of 51 patients with postoperative complications, including 3 cases of acute tubular necrosis, 6 cases of acute rejection, 2 cases of CsA liver and kidney poisoning, 5 cases of lung infection, Failure in 3 cases, 1 case of cerebral hemorrhage. The survival rates of 1, 3 and 5 years were 47, 45 and 42 respectively. The survival rates of kidney, kidney and kidney were respectively 46, 44 and 41 cases, and the survival rates at 1, 3 and 5 years were 92.2% / 90.2% and 88 2% / 86 3%, 82 4% / 80 4%. Conclusion: ① good tissue matching and quality assurance for the kidney is the first step in the success of renal transplantation in the elderly; ② according to the characteristics of elderly patients to do all the perioperative work, take appropriate measures for elderly patients with renal transplantation can be Achieved satisfactory results; ③ rational use of immunosuppressive agents is an important guarantee to improve the transplant effect.