夫妻间活体供肾肾移植的疗效分析

目的：总结夫妻间活体供肾肾移植的临床经验。方法：回顾分析2004—2008年实施夫妻间肾移植14例的临床资料,妻子作为供体9例,丈夫作为供体5例。收集供受体基本信息及手术方式、术后免疫抑制剂方案和随访结果,分析受体的临床疗效。结果：8例（57.1%）采用手助腹腔镜方式取肾,6例（42.9%）采用小切口开放方式取肾。12例（85.7%）以左肾作为供肾,2例（14.3%）以右肾作为供肾。受体全部应用激素＋CNI类免疫抑制剂＋抗代谢类免疫抑制方案,8例患者接受免疫诱导（57.1%）。随访1~4年,因肺部重症感染死亡1例,转为血液透析1例,1年受体/移植肾存活率分别为92.9%和85.7%。介入B超穿刺移植肾6例,病理结果示3例正常,3例（21.4%）出现不同程度细胞排斥反应。结论：亲属移植成为治疗终末期肾病的主要手段,夫妻间肾移植效果良好。

Clinical Analysis on Living Renal Transplantation between Spouses

Objective：To introduce one-center experience on kidney transplantation between spouses.Methods： From 2004 to June 2008,Nine cases of wife-to-husband and five cases of husband-to-wife transplantation were practiced in our center.This retrospective study examined data on renal transplant donors and recipients.Demographic information about the study population was summarized using simple statistical method.Results： Eight donors underwent hand-assisted laparoscopic nephrectomy while five cases underwent open nephrectomy.Two donors donated right kidneys and 12 donors donated left kidneys.All recepients received triple combined immunosuppressive protocols consisted of calcineurin inhibitors（CNI）,MMF/ Aza and steroid.Eight cases performed immunity induction therapy.All recipients were followed up 1 to 4 years.One recepient died,one recepient continued hemodialysis.Six recipients took biopsy of the allograft,while three recipients had acute rejection at different degrees.Conclusions： Living related renal transplantation is the treatment of choice for the majority of patients with end-stage renal disease（ESRD）.Renal transplantation between spouses has a good outcome.