移植肾动脉血栓形成的原因与对策

目的：探讨移植肾动脉血栓形成的原因和预防措施.方法：报告5例移植肾动脉血栓形成患者的临床资料.结果：1例动脉血栓发生于术中,4例分别发生于术后第2、5、10、12天.4例诊断明确后行移植肾切除术,另1例取出了肾动脉和肾静脉内的血栓,恢复了移植肾血供,但终因移植肾未恢复功能而切除.结论：移植肾动脉血栓形成多发生于术后早期,其主要原因与外科吻合技术相关,另外还与动脉粥样硬化、动脉分支多,以及冷缺血时间过长等有关.该并发症预后差,应以预防为主,早期诊断和及时手术治疗是关键.

Etiology and prevention of thrombosis of the allografted renal artery

Objective:To analyze the etiology, clinical manifestation,diagnosis,therapy and prevention of transplanted renal artery thrombosis.Methods:Clinical data of 5 cases of patients with postoperative allograft renal artery thrombosis were reviewed.Results:One case was noted having allograft renal artery thrombosis during operation.Four cases were noted postoperatively on 2,5,10,12 day respectively.Four of the 5 cases underwent graft nephrectomy upon definite diagnosis.one was subjected to the thrombectomy in renal artery and renal vein and the blood supply of allograft kidney was recovered,but the patient underwent graft nephrectomy at last because of graft dysfunction.Conclusions:The grafts artery thrombosis usually occurred in early period after transplantation.In addition to atherosclerosis,rami of artery,prolonged cold ischemic time,surgical anastomoses technique are the most important causes of graft thrombosis.Transplanted renal artery thrombosis had a poor prognosis,so the prevention is vital.Early diagnosis and immediate operation are the treatment of choice for transplanted renal artery thrombosis.