1 124例次肾移植回顾分析

目的　总结肾移植的经验 ,提高长期存活率。方法　总结 1978年 7月至 2 0 0 1年 10月的 112 4例次肾移植经验。分析术前准备、组织配型、供肾质量、手术操作、并发症防治、免疫抑制剂使用等方面对肾移植效果的影响。结果　 1、3、5年人 /肾存活率 ( % )分别为 :83 .1/70 .3、74.6 /6 8.6和6 2 .6 /5 6 .1。淋巴毒试验 >2 %和 <2 %的肾移植群体中 ,发生超急性排斥反应 (AR)、加速性排斥反应 (HAR)的百分率差异无显著性。 335例术前行HLA血清学分型的患者 ,与 5 5 0例单纯行淋巴毒试验比较 ,前者肾移植中HAR发生率明显减少 ;在 2 0 0 0年以后的 130例肾移植中 ,AR和HAR发生率较早期 5 5 0例均有所下降。结论　充分的术前准备、良好的组织配型、供肾质量以及手术技巧的掌握是肾移植成功的关键。减少并发症、合理应用免疫抑制剂、个体化给药和长期随访是提高肾移植长期存活率的保证。

Retrospective analysis on 1 124 case-times of renal transplantation

Objective To sum up the experience of renal transplantation in order to improve transplant effect and enhance the long-term survival and recovery rate.Methods The data of renal transplantation of 1 124 cases who received renal transplantation from Jul. 1978 to Oct. 2001 were summarized. All the possible factors that could influence the transplant effect such as pre-operative preparation, HLA match, donors' quality, surgical procedure, immunosuppressive therapy and so on were analyzed. Results The 1-, 3-, 5-year survival rate (%) of patient/kidney was 83.1/ 70.3, 74.6/ 68.6 and 62.6/ 56.1 respectively. The rate of AR was decreased significantly from 3.09?% only with LXM to 0.89?% with LXM test in combination with HLA serological test. The rate of HAR and AR in 130 cases with additional PRA test were lower than those only with LXM test.Conclusions The well pre-operative preparation, the ideal HLA match, the high quality of donor's kidney and transplant operation were keys for successful renal transplantation. Reduction of the complications, individual and combined medication in reason and long-term follow-up were very important in the long-term survival time.