早期排斥反应致移植肾功能延迟恢复的临床分析

目的探讨肾移植术后早期排斥反应所致移植肾功能延迟恢复(DGF)的诊断、治疗方案及效果,对远期人/肾存活的影响。方法回顾分析1999年4月~2003年4月肾移植术后早期排斥反应所致DGF患者的临床资料,共35例。结果24例术后无尿,11例术后2~5d出现少尿、无尿。经临床、彩超、移植肾穿刺活检诊断为排斥反应。所有患者接受ATG加FK506加MMF加Pred免疫抑制方案,定期透析。治疗后平均来尿时间为25d(10~98d),6个月内32例肾功能恢复正常,3年人存活率97.14%(34/35),移植肾存活率94.29%(33/35)。32例有功能肾患者的平均尿量为(1 986.4±869.7)ml/d,血肌酐(101.5±57.3)μmol/L,尿素氮(7.9±2.76)mmol/L。结论早期排斥反应所致DGF应尽早采用ATG加FK506加MMF加Pred免疫抑制方案,绝大多数都能恢复,远期人/肾存活良好。

Clinical study on delayed graft function caused by early rejection after renal transplantation

Objection To discuss the diagnosis,treatment and effects of early rejection-caused delayed graft function(DGF) on patient/graft survival after renal transplantation.Methods Clinical data of 35 patients with early rejection-caused DGF after renal transplantation from April 1999 to April 2003 were retrospectively analyzed.Results Early rejection-caused DGF of 35 cases were diagnosed by clinical characters,colorful ultrasonography,renal transplant biopsy pathology.All received the immunosuppressive strategy with ATG,FK506,MMF and Pred.Urine output increased in mean 25d after treatment.The renal function of 32 cases returned to normal level within 6 months.The rates of patient/graft survival of 3 years were 97.14%(34/35) and 94.29%(33/35)respectively.Conclusion Early rejection-caused DGF can return after treatment with ATG,FK506,MMF and Pred and do not affect the long term patient/graft survival.