实用器官移植电子杂志 ›› 2018, Vol. 6 ›› Issue (6): 440-443.DOI: 10.3969/j.issn.2095-5332.2018.06.007

• 论著 • 上一篇    下一篇

亲属活体肾移植受者术后并发症的诊治分析

王淮林,刘斌,朱海冬,王钢,王远涛,周洪澜,翟秀宇   

  1. 吉林大学第一医院泌尿系统 疾病诊治中心,吉林 长春 130021
  • 出版日期:2018-11-20 发布日期:2021-06-24
  • 基金资助:
    国家自然科学基金面上项目(81671574,81470975)

Diagnosis and treatment of postoperative complications of living donor kidney transplant recipients

Wang Huailin,Liu Bin,Zhu Haidong,Wang Gang,Wang Yuantao,Zhou Honglan,Zhai Xiuyu   

  1. Diagnosis and Treatment Center of Urinary System Diseases in the First Hospital of JiLin University,Changchun 130021,Jilin,China
  • Online:2018-11-20 Published:2021-06-24

摘要:

目的 总结 235 例亲属活体肾移植受者术后并发症的发生情况,提高肾移植术后并发症的诊 治效果。方法 回顾性分析本院 2012 年 1 月— 2017 年 6 月收治的 235 例亲属活体受者的临床资料,对其术 后恢复情况、并发症进行分析。结果 235 例受者出院时血肌酐为 100.1 μmol/L,其中 1 例因呼吸衰竭死亡, 4 例移植肾失功,余 230 例受者近期复查血肌酐为 111.8 μmol/L。随访 6 ~ 59 个月,并发症包括急性排斥反应、 肺部感染、尿路感染、切口感染、移植肾动脉感染、带状疱疹、尿瘘、移植肾输尿管梗阻、移植肾功能延 迟恢复、移植肾动脉狭窄、移植肾失功、免疫抑制剂中毒、药物性腹泻、骨髓抑制、肝功能不全、移植后 糖尿病等。受者和移植肾的 1 年生存率分别为 99.8%、98.7%。术前使用抗胸腺细胞球蛋白(antithymocyte, ATG)或巴利昔单抗诱导可明显降低术后排斥反应的发生(P < 0.05)。结论 术前充分评估、术中精细操作、 术后严密随访和及时治疗术后并发症,可有效提高移植肾的生存率。

关键词: 亲属活体受者 , 并发症 , 诊治

Abstract:

Objective To summary the incidence of postoperative complications in 235 living donor kidney transplantation recipients,and improve diagnosis and treatment of complications after renal transplantation. Methods A retrospective analysis of the clinical data of 235 living donor kidney transplantation recipients admitted from January 2012 to June 2017 in the First Hospital of JiLin University,to analyze its postoperative recovery and complications. Results The mean serum creatinine was 100.1 μmol/L when 235 recipients leaving hospital,with 1 case died of respiratory failure and 4 cases of renal allograft failure,the recent reexamination of serum creatinine was 111.8 μmol/L in the remaining 230 patients. Following up for 6 ~ 59 months, complications included acute rejection,pulmonary infection,urinary tract infection,wound infection,renal artery infection,herpes zoster,urinary fistula and ureter obstruction after renal transplantation,delayed graft function, renal artery stenosis,renal allograft failure,immunosuppressant drug poisoning,diarrhea,myelosuppression, hepatic insufficiency,transplantation diabetes. The 1 year survival rates of the recipients and the transplanted kidneys were 99.8% and 98.7%,respectively. Preoperative use of antithymocyte(ATG)or bariximab could significantly reduce the incidence of postoperative rejection(P < 0.05). Conclusion The survival rates of the transplanted kidney could be improved effectively in some methods,such as preoperative comprehensive assessment,intraoperative detailed operation,regular follow-up and timely intervention of complications after operation.

Key words: Living donor kidney transplantation recipients, Complication, Diagnosis and treatment