影响再次肾移植临床效果的主要因素

目的:探讨影响再次肾移植临床效果的主要因素.方法:报告我院115例再次肾移植患者的临床资料,并与同期首次移植患者的人/肾存活率对比观察.结果:两组间1、3、5年受者存活率的差异无统计学意义;而移植肾的存活率再次移植组明显低于对照组(P<0.05).再次肾移植受者淋巴毒试验<59例,5%～10(例,>10%9例,其移植肾存活率分别为72%、31%、0%.再次肾移植受者PRA<10C例,>10例,其术后急性排斥反应发生率分别为30.2%、75.0%.术后排斥反应、感染、肝功能损伤的发生率,再次移植组高于首次移植组(P<0.05);高血压、高血脂、糖尿病的发生率两组未见显著性差异.结论:再次移植肾存活率低于首次移植;术前PRA、淋巴毒水平是影响再次肾移植效果的主要因素;术后排斥反应、感染及肝功能损伤的发生率高于首次肾移植.

Effects of kidney retransplantation and associated factors

Objective:To summarize the effects of renal retransplantation and the associated factors.Methods:Clinical data of 115 cases receiving first renal transplantation and 115 cases receiving renal retransplantation during July 1978 to October 2006 were retrospectively analyzed.Results:No significant difference in the patient survival rates was noted between the two groups, while the graft survival rate in the retransplantation group was lower than that in the first transplantation group. Complement dependent cytotoxity test(CDC) before retransplantation was noted <5% in 39 cases, 5%-10% in 28 cases and >10% in 9 cases,with the graft survival rates at one year 72.0%,31.0% and 0% respectively. Panel reactive antibody(PRA) before retransplantation was <10% in 43 cases and >10% in16 cases, with incidence of acute rejection 30.2% and 75.0% respectively. The incidence of acute rejection , impaired liver function and infection were significantly higher in retransplantation group than that in the first transplantation group(P<0.05). No significant difference in the rates of hypertension, hyperlipemia and diabetes was noted between the two groups (P>0.05).Conclusions:In patients with retransplantation, the survival rates of graft was lower than that in the first transplantation. PRA and CDC before retransplantation were important influencing factors of renal retransplantation.