单支与多支移植肾动脉的移植效果观察

目的 比较单支与多支移植肾供肾动脉的移植效果.方法 根据供肾动脉的支数将患者分为3组,A组为单支肾动脉组(251例);B组为2支肾动脉组(12例),但有1支动脉直径<2 mm或估计供血区域<10%.将该动脉结扎(上极动脉);C组为2支或2支以上肾动脉组(35例).分别观察记录3组患者的手术时间、术中失血量、术后并发症以及术后肾功能情况.结果 A、B两组的手术时间较C组短,但差异无统计学意义(均P>0.05).3组的失血最差异无统计学意义(均P>0.05).3组患者术后的肌酐差异无统计学意义(均P>0.05).A组有7.6%(19/251)出现术后并发症;B组有2例出现肾功延迟恢复,无其他并发症,并发症发生率为16.7%(2/12);C组有11.4%(4/35)出现并发症.术后各组1年人/肾存活率差异无统计学意义(P>0.05).结论 单支与多支移植肾供肾动脉组之间比较,除手术时间略长外,在术中失血量、术后并发症、术后肾功能情况、术后急性排斥反应发生率、术后1年人/肾存活率方面均无明显差异.提高血管重建吻合技术是减少多支供肾动脉术后并发症,提高移植肾存活率的关键.

Outcomes of renal transplantation with donor kidneys with multiple arteries

Objective To compare the outcomes of renal transplantation with donor kidneys with multi-branched renal arteries.Methods The data about operation time,volulne of intra-operational blood loss,postoperative complications,and post-operational renal function status of 251 recipients of donor kidneys with single-branched renal artery(Group A),12 recipients of donor kidneys with double-branched renal arteries the diameter of one of which was<2 mm or the estimated blood supply areas of one of which were<10%(Group B).and 35 recipients of donor kidneys with renal arteries with 2 or more than 2branches(Group C).Results The operation time Was(115±34)min in Group A and was(120±31)rain in Group B,both shorter than that of Group C[(133±55)win],however,not significantly.There were not significant difierences in the intra-operational volme of blood loss.1-year survival rate of patient/transplanted kidney,and post-operational ereatinine level among these three groups.The complication rate WaS 7.6%(19/251)in Group A,16.7%(2/12)in Group B,and 11.4%in Group C(4/35).Conclusion There are not signitlcant differences in the intra-operational status and post-operational outcomes among the operations of renal transplantation with donor kidneys with different mounts of renal arteries.