动静脉内瘘关闭修复术在肾移植中的应用

目的：探讨动静脉内瘘关闭修复术对心功能的影响，以扩大同种异体肾移植适应证。方法：对８例长期血液透析反复出现心力衰竭者在肾移植前５个月行动静脉内瘘关闭修复术。结果：心腔恢复正常７例，心腔内径在正常上限１例。肾移植成功６例，肝功能衰竭死亡１例，自发性肾破裂作肾切除１例。结论：肾移植前先行动静脉内瘘关闭修复术有利于改善患者心、肺功能，扩大手术适应证，减少并发症，为肾移植创造有利条件。

The repair of arteriovenous fistula before renal transplantation

Purpose:In order to investigate the effects of repair of arteriovenous fistula on heart function so as to widen the range of the indication of allogenetic transplantation of kidney.Methods:Repair of arteriovenous fistula was performed in 8 patients who have received long term hemodialysis and then complicated with repeated attack of heart failure 5 months before renal transplantation.Results:There are 7 patients had their cardiac chambers returned to normal, and 1 returned to normal upper limit. Renal transplantation was successfully performed in 6 patients, but death occurred in 1 case resulting from liver function failure. Superacute rejection and spontaneous rupture of the kidney occurred in 1 patient.Conclusions:It is considered that the repair of arteriovenous fistula before renal transplantation is beneficial to improvement of heart function in these patients so as to widen the range of operative indications and create favourable condition for renal transplantation and decrease complications. Color doppler sonography is of great value in monitoring pre-and postoperative heart function.