高龄活体亲属供肾移植14例临床分析

 目的 比较高龄活体亲属供肾移植与标准活体亲属供肾移植的临床效果。 方法 回顾性分析高龄活体亲属供肾移植14例、标准活体亲属供肾移植84例的临床资料，并对供/受体进行回访，比较两组供肾移植术后供/受体的肾功能恢复情况及移植肾功能恢复延迟发生率、急性排斥反应发生率、存活率。 结果 高龄供体及标准供体间手术前后肾功能的变化量无显著差异（P>0.05）；移植肾功能恢复正常时间在高龄供肾组为（4.2 ± 2.1）d，在标准供肾组为（3.3 ± 1.6）d，两组间无显著差异（P>0.05）；高龄供肾组和标准供肾组移植肾急性排斥反应发生率分别为14.3%和9.8%，移植肾功能恢复延迟发生率分别为21.4%和11.0%，移植肾存活率在分别为92.9%和98.8%。 结论 术前对高龄供体进行严格筛选及全面综合评估，高龄活体亲属供肾移植同样也是安全有效的。

Clinical features of HIV-negative plasmablastic lymphoma (PBL): analysis of 11 cases

To accumulate more experience on diagnose and treatment of HIV-negative plasmablastic lymphoma (PBL),clinical characteristcs,treatment options and prognosis of 11 HIV negative PBL cases,including 8 males and 3 females,were analysed retrospectively from Jan.2007 to Dec.2017 in Zhongshan Hospital,Fudan University.The median age was 45 years,and 5 patients were over 60 years old.These patients were all extra-nodal involvement as origin,and 6 cases were gastrointestinal involvement.According to Ann Arbor staging,9 cases were at Ⅳ stage,1 case was at Ⅲ stage,and the left one could not be staged.All patients' tumor cells expressed plasma cell-specific markers.Eight cases were CD20 negative,and 2 cases were weakly positive.The median Ki67 was 75%.Seven patients were treated with CHOP-like regimen,and 1 case of them was also treated with bortezomib,2 cases of them achieved complete remission.Among the other 4 cases,1 case treated with EPOCH was lost after disease progression,1 case treated with EP regimen,1 case treated with lenalidomide-based regimen,and 1 case treated with Chinese medicine treatment were all dead.The median progression-free survival time was 4.9 months,and the median survival time was 7.8 months.Therefore,HIV-negative PBL in our center was highly invasive,male and old were susceptible,and the gastrointestinal tract was easily involved.The efficacy of CHOP-like regimen was frustrating,but early treatment might be helpful.