移植肾有功能的肾移植患者死亡原因分析

目的:探讨移植肾有功能的肾移植术患者死亡的原因。方法:对87例移植肾有功能的死亡肾移植患者的临床资料进行分析。结果:死于感染者35例,死于心血管疾病者19例,死于脑出血者10例,死于肝脏疾病者9例,死于肿瘤6例,死于自杀4例,死于消化道出血2例,原因不清者2例。结论:感染是肾移植患者有功能死亡的首位原因,心脑血管疾病是患者死亡的重要原因。重视移植肾有功能的肾移植患者死亡的发生并加以积极干预,可以提高患者的长期生存率。     

187例肾移植受者死亡原因分析

目的分析肾移植受者的死亡原因。方法回顾性分析1978年至2003年期间进行同种肾移植的1400例受者资料。对肾移植后受者的死亡率、死亡原因和时间进行分析。结果1400例肾移植受者中,共死亡187例,死亡率为13.36%。187例受者的死亡原因依次为感染、心脑血管疾病和肝功能衰竭;所占比率分别为37.97%、31.56%和14.97%。死亡的受者中,移植肾有功能的87例,占46.5%。结论感染、心脑血管疾病及肝功能衰竭是肾移植后受者死亡的主要原因。将近一半的受者死亡时移植肾有功能。     

胰肾联合移植53例术后长期存活的临床观察

目的 分析53例胰肾联合移植长期存活情况及其影响因素.方法 回顾性分析2000年1月至2009年6月间施行的53例胰肾联合移植受者和移植物长期存活情况,分析受者死亡原因和移植物功能丧失原因.结果 3、5和8年受者存活率分别为90.1％、89.1％和80.0％,3、5和8年移植胰腺存活率分别为84.9％、84.8％和60.0％,3、5和8年移植肾存活率分别为83.0％、82.6％和53.3％.受者死亡原因分别为感染(4例)、移植肾功能丧失(2例)、心血管急症(1例)和脑卒中(1例).移植胰腺功能丧失的主要原因为带功能受者死亡、排斥反应和外科并发症.移植肾功能丧失的主要原因为排斥反应和带功能受者死亡.结论 胰肾联合移植治疗终末期糖尿病肾病远期效果良好,感染、排斥反应和外科并发症是受者死亡和移植物功能丧失的主要原因.     

婴幼儿单供肾成人受者移植39例报道

目的总结婴幼儿单供肾成人受者肾移植的临床近期效果。方法 2014～2016年间接受3岁以下婴幼儿单供肾移植的成人受者39例,依据供者年龄分为0～1岁婴儿供肾组(9例)和1～3岁幼儿供肾组(30例),统计术后1年内肾存活情况、肾功能状况、移植肾功能延迟恢复(DGF)发生率及并发症情况。结果两组术后未见原发性无功能(PNF)和外科并发症导致的移植肾失功病例,婴儿供肾组死亡2例,死因均为间质性肺部感染;幼儿供者组死亡2例,死因分别为肺部感染与不明原因猝死,死亡删失的移植肾存活率两组均为100%。两组受者术后1年的血肌酐水平分别为(74.14±18.52)μmol/L和(91.46±26.91)μmol/L,差异无统计学意义(P0.05)。DGF发生率,婴儿供肾组44.4%(4/9),幼儿供肾组26.7%(8/30),差异无统计学意义(P0.05);两组术后蛋白尿发生率分别为33.3%和36.7%,差异无统计学意义(P0.05)。结论婴幼儿单供肾移植给低体重成人受者,移植肾近期存活效果良好,可扩展器官来源。但是术后早期蛋白尿发生率较高,可能与供肾高滤过损伤有关。     

再次肾移植受者和移植肾长期预后影响因素分析

目的探究再次肾移植受者和移植肾存活情况及长期预后影响因素。 方法回顾性分析1991年1月1日至2017年12月31日于浙江大学医学院附属第一医院肾脏病中心接受肾移植受者临床资料。共纳入再次肾移植受者37例,首次肾移植受者5 374例。根据再次肾移植受者移植肾存活时间长短,将其分为长期存活组(19例,>5年)和短期存活组(18例,≤5年)。采用成组t检验比较长期和短期存活组供受者年龄、首次与再次肾移植间隔时间、HLA错配数和再次移植供肾冷/热缺血时间。采用卡方检验比较长期和短期存活组受者性别、再次移植供肾类型、再次移植前后群体反应性抗体阳性比例、首次移植失功移植肾切除比例、再次移植前免疫诱导比例及再次移植后移植肾功能延迟恢复(DGF)和急性排斥反应发生比例。采用Kaplan-Meier法分析再次和首次肾移植受者/移植肾1、5和10年存活率。采用Cox比例风险模型分析影响再次肾移植术后移植肾长期存活影响因素。P<0.05为差异有统计学意义。 结果截至2018年3月1日,37例再次肾移植受者中位随访时间为152个月(11～323个月),2例死亡,18例发生移植肾失功,17例移植肾功能稳定。5 374例首次肾移植受者中位随访时间为108.9个月(0.1～350.0个月),459例死亡,1 343例发生移植肾失功。再次移植组受者/移植肾1、5和10年存活率分别为86%/81%、86%/62%和82%/36%,首次移植组受者/移植肾1、5和10年存活率分别为99%/98%、93%/89%和88%/80%。再次移植组移植肾1、5和10年存活率均低于首次移植组(χ²＝60.816、25.110和43.900,P均<0.05);再次移植组受者1年存活率低于首次移植组,差异有统计学意义(χ²＝40.409,P<0.05)。长期和短期存活组受者再次移植后移植肾DGF和急性排斥反应发生比例差异均有统计学意义(χ²＝4.039和4.748,P均<0.05)。Cox回归分析结果示DGF和急性排斥反应是影响再次肾移植受者移植肾长期存活的独立危险因素,差异有统计学意义(RR＝4.317和4.571,P均<0.05)。 结论再次肾移植受者移植肾存活率低于首次肾移植受者,DGF和急性排斥反应是影响再次移植受者移植肾存活的独立危险因素。     

低龄婴儿双供肾移植给成人22例报道

目的总结单中心低龄婴儿双供肾移植给成人的临床效果。方法回顾性纳入2013年7月至2017年10月华中科技大学同济医学院附属同济医院实施的所有儿童双供肾移植给成人受者共22例临床资料和随访数据。22例供者年龄(2.9±1.7)个月,体重(4.9±1.4)kg,其中15例小于3月龄。受者多为低体重女性成人,体重(46.3±5.6)kg。总结早期移植失败及随访期间移植肾失功或受者死亡原因。根据是否发生单侧移植肾血栓,移植肾功能恢复者又进一步分为双肾存活组和单肾存活组,比较移植肾中-长期功能。结果4例受者在术后早期出现移植失败,包括双肾血栓2例、移植肾破裂切除1例和受者多器官功能衰竭死亡1例。18例受者移植肾功能恢复出院,随访期间因移植肾新生肿瘤切除双肾1例、因复杂全身原因死亡1例、因间质性肺炎死亡1例,余15例受者双肾均存活者10例(中位随访59个月),单肾存活者5例(中位随访48个月)。移植1年时双肾存活组估算肾小球滤过率为(95±27)ml/(min·1.73 m2),显著高于单肾存活组(61±24)ml/(min·1.73 m2)(P<0.05),但3年时分别为(95±21)ml/(min·1.73 m2)和(69±31)ml/(min·1.73 m2),差异缩小,差异无显著统计学意义(P=0.12)。结论低龄婴儿双供肾移植虽然可以扩大供肾来源,但发生早期移植失败和单肾栓塞的风险较高。在单肾存活的情况下,受者仍具有相对满意的中-长期移植效果。     

婴幼儿双供肾成人肾移植临床效果研究

目的探讨婴幼儿双供肾成人肾移植的临床疗效。方法回顾性分析2012年12月至2020年11月中山大学附属第一医院25例婴幼儿双供肾成人肾移植的供、受者临床资料。计算术后1、3、5年受者和移植肾存活率,观察受者术后肾功能恢复情况及术后不良事件发生情况。结果25例婴幼儿双供肾成人肾移植受者的第1、3、5年存活率均为95.8%,移植肾及死亡删失移植肾的第1、3、5年存活率均为87.2%。1例受者因急性下壁心肌梗死死亡,3例受者分别因移植肾血管血栓形成或输尿管狭窄、尿漏导致移植肾功能丧失。除受者移植肾功能丧失及死亡外,术后1、2、3年估算肾小球滤过率分别为:(99.35±21.78)ml/(min·1.73 m2)、(103.11±29.20)ml/(min·1.73 m2)、(114.99±28.55)ml/(min·1.73 m2)。结论婴幼儿器官捐献供肾的双肾成人肾移植的总体移植效果较满意,做好供、受者匹配,规范供肾获取及手术流程,加强围术期管理可提高成人受者长期疗效,可作为扩大供者来源的重要途径。     

肾移植术后供者特异性抗体对移植肾近期效果的影响

目的 评价肾移植术后供者特异性抗体(Ds-Ab)对移植肾近期效果的影响。方法 对2001年1月至2002年7月间进行尸肾移植的92例受者，使用酶联免疫吸附(ELISA)法，检测受者血清中HLA抗体水平，随访1年。结果 16例(17．4％)受者术后出现供者特异性抗体。抗体阳性组急性排斥发生率(56．3％)高于抗体阴性组(11．9％)，P=0．000；移植肾功能延迟恢复的发生率(12．5％)与抗体阴性组(9．2％)比较，差异无显著性，P=0．102；供者特异性抗体阳性组受者发生急性排斥后，移植肾肌酐水平高于抗体阴性组或无急性排斥组。结论 供者特异性抗体与肾移植术后急性排斥有关，可能影响近期移植肾功能。     

胰肾联合移植术后外科并发症的临床分析

目的 分析胰肾联合移植术后外科并发症发生情况、手术治疗及结果.方法 统计2000年1月至2011年12月施行的胰肾联合移植术60例,根据术后是否发生外科并发症将受者分为并发症组及无并发症组,分析手术治疗的原因,评估再次手术对受者及移植物存活率的影响.结果 术后1年内,受者死亡原因主要为肺部感染(3例)、心脑血管意外(2例)、消化道出血(1例).感染及心脑血管意外是导致受者术后早期死亡的主要原因(5/6).56例胰腺手术成功,术后(14± 8)d完全停用胰岛素,外科并发症导致移植胰腺切除4例.15例移植肾功能恢复延迟,术后接受透析的时间为(33±12)d,其余受者肾功能均在术后2～7 d恢复正常,带移植物功能死亡是移植肾丢失的主要原因(3/6).外科并发症发生率为25％ (15/60).外科并发症主要包括:出血、切口感染、移植胰腺血管栓塞及移植胰胰腺炎,外科并发症降低了术后1年受者及移植胰腺的存活率,而对肾脏的存活率无明显影响.结论 胰肾联合移植术后外科并发症发生率高,明显降低了受者和移植胰存活率,是影响术后早期受者和移植胰存活的主要因素.     

移植前活检Remuzzi高评分供肾移植的临床观察

目的初步观察Remuzzi评分高的器官捐献供肾移植给成人受者的近期效果。方法回顾性分析2019年1月至2019年12月间华中科技大学同济医学院附属同济医院接受了移植前活检Remuzzi评分4分及以上心死亡器官捐献供者供肾移植的受者31例, 分为双肾移植组(DKT组, 14例)和单肾移植组(SKT组, 17例)。Remuzzi平均评分为DKT组左肾5.05/右肾5.26, SKT组左肾4.92/右肾4.58。双供肾植入受者同侧髂窝。统计术后1年内的受者/肾存活情况、肾功能状况及急性排斥反应、移植肾功能延迟(DGF)和蛋白尿等并发症情况。结果 DKT组和SKT组的受者男性占比分别为92.9%比52.9%, 体重指数分别为(23.93±2.56)kg/m2比(21.09±2.85)kg/m2, 两组间差异有统计学意义(P<0.05)。DKT组1例术后11个月移植肾功能丧失, 移植肾1年存活率92.9%, 受者存活率100%, SKT组受者/移植肾1年存活率均为100% 。术后12个月的血肌酐(SCr), DKT组为(164±37.7)μmol/L, SKT组(154.92±96.2)μ...     

Analysis of cause of death with a functioning graft: a single-center experience

INTRODUCTION: After the introduction of new immunosuppressants, such as tacrolimus and mycophenolate mofetil, we have achieved excellent results for kidney transplantation with a low acute rejection rate. Currently, nonimmunological factors are considered to be the main cause of graft loss for long-term transplant patients. In this study, we analyzed the cause of death with a functioning graft. PATIENTS AND METHODS: We performed 1375 cases of living kidney transplantation (LKT) and 219 cases of cadaveric kidney transplantation (CKT) between January 1983 and December 2002. Of these patients, 86 LKT patients and 19 CKT patients died with a functioning graft. RESULTS: The mean duration of graft function was 4.8 +/- 4.5 years. The incidence of the causes of death were: infection, 24%; stroke, 17%; cardiovascular disease, 16%; malignant disease, 15%; hepatic failure, 11%; gastric ulcer, 4%; and accident/suicide 2%. Five- and 10-year graft survivals for LKT were 80.2 and 62.0%, respectively. The corresponding values for patients (with the exception of the patients who died with a functioning graft) was 83.0% and 66.1%, respectively. The 5- and 10-year graft survival rates for cadaveric kidney transplants were 70.8% and 48.9%, respectively. The corresponding values for patients (with the exception of the patients who died with a functioning graft) were 75.3% and 52.6%, respectively. CONCLUSION: To prevent death with a functioning graft, management of vascular disorders such as stroke and cardiovascular disease, malignant disease, and infectious disease is crucial for kidney transplant patients.     

LifePort保存心脏死亡器官捐献供肾的临床研究

目的:探讨采用LifePort保存心脏死亡器官捐献(DCD)供肾对移植肾功能恢复的影响。方法:分析解放军三〇三医院2012年8月~2013年10月期间30个DCD案例肾移植后受者的临床资料。根据同一供体两只供肾采用不同的保存方式,随机分入LifePort组(n=30)和普通冷藏组(n=30例),比较两组受者肾功能恢复延迟(DGF)、急性排斥反应(AR)等并发症的发生率及移植肾功能恢复等情况。结果:LifePort组受者的DGF发生率为20%(6/30),而普通冷藏组的DGF发生率为46.7%(14/30),差异有统计学意义(P0.05)。两组间AR发生率、围手术期移植肾存活率及受者存活率的差异无统计学意义(P0.05)。LifePort组受者术后出院时血清肌酐恢复优于普通冷藏组,且平均住院时间较短,差异有统计学意义(P0.05)。结论:LifePort能有效改善离体DCD供肾的保存质量,降低受者DGF发生率,有利于移植肾功能恢复。     

Association of Cytomegalovirus Infection and Disease With Death and Graft Loss After Liver Transplant in High‐Risk Recipients

In the era of effective antiviral chemoprophylaxis, cytomegalovirus (CMV) disease has been inconsistently associated with increased mortality in liver transplant (LT) recipients. A retrospective study evaluating the association of CMV infection and disease occurring within 1 year of transplant with the endpoints of death or the combined endpoint of graft loss or death was undertaken in a cohort of 227 CMV donor seropositive, recipient seronegative first LT recipients. Associations were evaluated using Cox proportional hazards regression models. CMV infection and disease occurred in 91 (40%) and 43 (19%) patients, respectively. Forty‐eight (21%) died while 58 (26%) sustained graft loss or death. In multivariable analysis, CMV infection was associated with an increased risk of death (RR: 2.24, p = 0.008) and graft loss or death (RR: 2.85, p < 0.001). CMV disease was also associated with an increased risk of death (RR: 2.73, p = 0.003) and graft loss or death (RR: 3.04, p = 0.001). CMV infection and disease occurring within the first year after LT in high‐risk recipients is associated with increased risk of death and of graft loss or death. Investigation of strategies to further reduce the risk of CMV infection and disease in high‐risk LT recipients is warranted.     

Intermediate outcomes of dual renal allografts: the University of Washington experience

PURPOSE: The increased survival advantage of renal transplantation with end stage renal disease combined with an increasing incidence of renal disease fuel an increasing disparity between supply and demand for transplantable kidneys. Despite efforts to increase cadaveric organ donation through education and publicity, the number of cadaveric kidneys transplanted has not increased and in the last year was surpassed by kidneys transplanted from living donors. In an effort to maximize cadaver organ donors use of kidneys from expanded criteria donors has been investigated. In select cases both donor kidneys have been transplanted into a single recipient, which is called dual renal transplant. We report on the 4-year dual renal transplant graft and patient outcomes and compare these to age matched single cadaver kidney transplants. MATERIALS AND METHODS: A retrospective review of 10 dual renal transplant recipients and 10 age matched single cadaver kidney recipients was performed. All patients underwent transplantation at our university between January 1996 and February 1998. Mean followup was 4.1 years (range 2.5 to 5.1) for the dual kidney recipients and 3.6 (0.0 to 5.5) years for the control group. RESULTS: Of the 10 dual renal transplant recipients 7 remain alive and 3 died of nontransplant related causes. Of the 10 single recipients 8 are alive, 1 died of postoperative complications and 1 died of nontransplant related causes. When censored for death with a functioning graft, 7 of 10 dual grafts are functioning at followup with a mean creatinine clearance of 39.4 ml. per minute (range 16.1 to 65.9) and mean serum creatinine of 2.0 mg./dl. (1.1 to 3.9). If not censored for death with a functioning graft, 50% of dual grafts are functioning. Of the 3 graft losses 2 were due to recurrent disease and 1 was attributed to chronic rejection. In the control group 8 of 10 grafts are functioning at current followup (regardless of censoring for death with a functioning graft) with a mean creatinine clearance of 48.7 ml. per minute (range 23.4 to 66.5) and mean serum creatinine of 1.6 mg./dl. (1.2 to 2.4). Of the 2 graft losses 1 resulted from postoperative complications and 1 was due to chronic rejection. CONCLUSIONS At the 4-year followup patients undergoing dual renal transplant have comparable graft function, incidence of graft loss and survival compared to the control group. However, because of our small sample size, differences in the 2 groups may be significant in a larger study. Additional studies need to be conducted to determine if this practice represents an acceptable use of kidneys from expanded criteria donors.     

Different etiologies of graft loss and death in Asian kidney transplant recipients: a report from Thai Transplant Registry

Background

Kidney transplantation is the most performed solid organ transplantation in Thailand. Over 4000 patients have received kidney transplantation from 23 centers within the kingdom. This study sought to demonstrate the causes of graft loss and death in Thai patients receiving kidney transplant during the past decade.

Patients and Methods

The Thai Transplant Registry database was used to evaluate the causes of graft loss and death. This database was established since 1997, a total of 2298 kidney transplants were available for analysis. Graft loss was defined as return to dialysis, graft removal, retransplantation, or death of the recipients. Patient survival was analyzed by all deaths.

Results

Among 2298 recipients, 59% received organs from deceased donors. The mean age at transplantation was 42 years (SD 12) and 61% were male. The most common identified causes of the end-stage renal disease were chronic glomerulonephritis (25.3%) and hypertensive nephropathy (11.3%); half of those were unknown. Actuarial graft survival rates at 1 and 5 years were 89% and 73%, respectively. The common causes of graft loss were chronic allograft nephropathy (53%), acute rejection (15%), death with a functioning graft (15%), and transplant renal artery diseases (7%). The greatest proportion (64%) of deaths was infection owing to septicemia and/or pulmonary infection. The others were from cardiovascular deaths (12%), liver disease (6%), and malignancy (4%).

Conclusion

Graft survival rates were comparable with previous reports. However, the proportion of death with functioning graft and cardiovascular death as a cause of graft and patient loss is lower than that of Caucasian populations.     

Association between serum resistin level and outcomes in kidney transplant recipients

Resistin is an adipocytokine that is associated with inflammation, coronary artery disease, and other types of cardiovascular disease among patients with normal kidney function. However, little is known about the association of resistin with outcomes in kidney transplant recipients. We collected socio‐demographic and clinical parameters, medical and transplant history, and laboratory data from 988 prevalent kidney transplant recipients enrolled in the Malnutrition‐Inflammation in Transplant—Hungary Study (MINIT‐HU study). Serum resistin levels were measured at baseline. Associations between serum resistin level and death with a functioning graft over a 6‐year follow‐up period were examined in unadjusted and adjusted models. The mean±SD age of the study population was 51 ± 13 years, among whom 57% were men and 21% were diabetics. Median serum resistin concentrations were significantly higher in patients who died with a functioning graft as compared to those who did not die during the follow‐up period (median [IQR]: 22[15–26] vs. 19[14–22] ng/ml, respectively; P < 0.001). Higher serum resistin level was associated with higher mortality risk in both unadjusted and fully adjusted models: HRs (95% CI): 1.33(1.16–1.54) and 1.21(1.01–1.46), respectively. In prevalent kidney transplant recipients, serum resistin was an independent predictor of death with a functioning graft.     

Determinants of Cardiovascular Mortality After Renal Transplantation: A Role For Cytomegalovirus?

Death with a functioning graft (DWF) is now the most common cause of late renal transplant failure, with cardiovascular disease its most frequent etiology. In some populations, infection with cytomegalovirus (CMV) increases risk of coronary disease. Few data exist regarding CMV and cardiovascular mortality after renal transplantation. We reviewed charts of 158 adult patients who died more than 90 days after receiving renal allografts and a matched cohort of 143 (of 2398) surviving patients transplanted at the University of Alabama at Birmingham between 1990 and 1998. Only advancing donor and recipient age increased risk of DWF; CMV infection did not. However, of 50 patients who died of cardiovascular causes, 94% were seropositive for CMV, while only 74% of the other 108 deaths occurred in CMV-seropositive patients (p < 0.05). Risk of cardiovascular death was greatest (p < 0.05) in patients with diabetes, advancing age, and CMV seropositivity. In renal transplant recipients, infection with CMV increases risk of death as a result of cardiovascular causes.     

Patient survival after renal transplantation: II. The impact of smoking

Renal transplant recipients have significantly higher mortality than individuals without kidney disease and the excess mortality is mainly due to cardiovascular causes. In this study, we sought to determine the impact of smoking, a major cardiovascular risk factor, on patient and renal graft survival. The study population included all adult recipients of first cadaveric kidney transplants done in our institution from 1984 to 1991. By selection, all patients were alive and had a functioning graft for at least 1 yr after transplantation. Smoking history was gathered prior to transplantation. The follow-up period was 84.3 + 41 months and during this time 28%, of the patients died and 21%, lost their graft. By univariate and multivariate analysis, patient survival, censored at the time of graft loss, correlated with these pre-transplant variables: age (p < 0.0001); diabetes (p = 0.0002); history of cigarette smoking (p = 0.004); time on dialysis prior to the transplant (p = 0.0005); and cardiomegaly by chest X-ray (p = 0.0005). Post-transplant variables did not correlate with patient mortality. By Cox regression, patient survival time was significantly shorter in diabetics (p < 0.0001), smokers (p = 0.0005), and recipients older than 40 yr. However, there were no significant differences between the survival of smokers, non-diabetics, diabetics, and older recipients. Patient death was the most common cause of renal transplant failure in smokers, in patients older than 40 yr, and in diabetics, but these patient characteristics did not correlate with graft survival. The prevalence of different causes of death was not significantly different between smokers and non-smokers. In conclusion, a history of cigarette smoking correlates with decreased patient survival after transplantation, and the magnitude of the negative impact of smoking in renal transplant recipients is quantitatively similar to that of diabetes.     

两种生物免疫诱导方案对肾移植受者的影响

目的评估肾移植受者中应用两种不同生物制剂进行免疫诱导治疗的疗效和安全性。方法回顾性分析2008年6月至2013年4月,在解放军第452医院泌尿外科暨成都军区泌尿外科中心应用生物制剂进行免疫诱导治疗的78例尸体肾移植受者的临床资料。根据应用免疫诱导方案不同分为两组,单克隆抗体组(A组,35例,接受巴利昔单抗治疗)和多克隆抗体组[B组,43例,接受抗胸腺细胞球蛋白(ATG)治疗]。另以同期在该院未接受免疫诱导治疗的肾移植受者作为对照组(C组,32例)。分析3组受者术后12周内的人、肾存活情况。监测3组受者术后7、14、30、60 d血清肌酐(Scr)水平变化。比较3组受者急性排斥反应、移植肾功能延迟恢复、感染等并发症的发生率。结果术后12周,3组受体人、肾存活率分别为A组100%和100%,B组97.7%和97.7%,C组100%和96.9%,各组间比较差异无统计学意义(均为P0.05)。术后7、14 d,与C组比较,A组和B组的Scr水平明显下降,差异均有统计学意义(均为P0.05)。与C组比较,A、B两组受者急性排斥反应发生率均降低,差异有统计学意义(均为P0.05);3组受者移植肾功能延迟恢复发生率比较,差异无统计学意义(均为P0.05)。B组受者术后感染发生率高于A组和C组,差异均有统计学意义(均为P0.05)。结论免疫诱导治疗在肾移植受者中应用安全有效。