夫妻间活体肾移植7例临床研究报告

目的总结7例夫妻间活体肾移植的经验．方法7例夫妻间活体肾移植，妻供夫6例，夫供妻1例．所有供体术前进行系统评估，开放手术取肾，右肾2例，左肾5例．术后采用环孢素A（或他克莫司）、硫唑嘌呤（或霉酚酸酯）及泼尼松预防排斥反应．结果7例供体术后10d出院，定期随访，最长者42月．所有供体血压、尿常规、肾功正常．受体／移植肾完全存活，移植肾存活最长时间42月．1例术后发生移植肾功能延迟恢复，血液透析治疗后，肾功恢复正常．结论夫妻间肾移植，虽然术前组织配型结果差，但供受者年纪轻，供肾质量高，移植效果好．其移植肾长期存活率与亲属活体供肾的相当．术前对供、受者应进行仔细全面综合评估是手术成功的保证．

Clinical Analysis in 7 Cases of Kidney Transplantation from pousal Donors

Objective To introduce the clinical experience in 7 cases from spousal renal donor transplantation. Methods 7 cases of kidneys transplants from spousal donors, 6 cases were wife-to-husband and one case was husband-to-wife. All potential living donors underwent fully preoperative systematic evaluation and received an open nephrectomy, in which 2 cases donated right kidneys and 5 cases donated left ones. Triple-combined immunosuppressive protocols consisted of calcineurin inhibitors （CNI） , MMF/Aza and steroid were postoperatively introduced for preventable rejection. Results 7 donors were discharged by ten days postoperatively. Every donor who was regularly followed up, （the longest time was for 42 months） , kept a normal renal function, normal blood pressure and good life quality. 7 recipients with 7 grafts still survived. One has survived over 3 years by now. One patient with delayed graft function （DGF） was cured by hemodia!ysis. Conclusions Spousal kidney transplantation shares comparable results with living related donor transplant （LRDT） , although their preoperative HLA matching is not so preferable, the graft-survival rate is similar to that of LRDT. This high survival rate is attributed to the fact that the age of donor and recipient is younger and the kidneys are uniformly healthy. Comprehensive accurate preoperative assessment of the donor and recipient is critical for the success of kidney transplantation from spouse.