CAJ | 학술논문

目的：探讨活体亲属供肾移植的意义和围手术期处理。方法：回顾分析11例亲属供肾移植临床资料。结果：11名供者分别为受者的父母、兄弟和妹妹，取左侧肾脏10例，右侧肾脏1例，取肾术历时2～3.5 h，热缺血时间1～3 min，所有供者术中、术后均未发生严重并发症，仅3例供者术后3周内出现一过性蛋白尿。11例受者均为首次移植，肾脏植入顺利，肾功能恢复良好，术后早期发生急性排斥反应2例，经甲基强的松龙冲击治疗后逆转。受者1年人／肾存活率为100％／100％，1例于术后1.5年死于肝功能衰竭，死亡时移植肾功能正常。结论：选择供者的主要内容是确定组织相容性是否适合和供者双肾形态及功能是否正常。活体取肾手术难度较高，对大部分供者来说，切取左侧肾脏较好。活体供肾移植的存活率明显高于尸体肾移植，应提倡活体亲属供肾。
목적：탐토활체친속공신이식적의의화위수술기처리。 방법：회고분석11례친속공신이식림상자료。 결과：11명공자분별위수자적부모、형제화매매，취좌측신장10례，우측신장1례，취신술력시2～3.5 h，열결혈시간1～3 min，소유공자술중、술후균미발생엄중병발증，부3례공자술후3주내출현일과성단백뇨。11례수자균위수차이식，신장식입순리，신공능회복량호，술후조기발생급성배척반응2례，경갑기강적송룡충격치료후역전。수자1년인／신존활솔위100％／100％，1례우술후1.5년사우간공능쇠갈，사망시이식신공능정상。 결론：선택공자적주요내용시학정조직상용성시부괄합화공자쌍신형태급공능시부정상。활체취신수술난도교고，대대부분공자래설，절취좌측신장교호。활체공신이식적존활솔명현고우시체신이식，응제창활체친속공신。
OBJECTIVE Living related renal transplantation(LRRT) is an important choice for uremic patients in face of shortage oforgan donors. Here we report our experience of LRRT in 11 cases and analyze the related risk factors for LRRT in China.METHODOLOGY 11 recipients received living related renal grafts between Jun 1996 and May 2000. The clinical data of boththe donors and the recipients were analyzed retrospectively. RESULTS The donors of the 11 recipients were parents, brothersor sisters. Donor evaluation included the separated kidney function test and image examination, with respect to ABO type matching,PRA detection, mix lymphocyte toxicity test, HLA typing and postoperative complications. Surgical procedures in graft harvestingand transplantation were also discussed. Nephrectomy was performed with anterior subcostal incision, with 10 of the left kindey and1 of the right. The warm ischemic time was between 1 and 3 minute. Transient proteinuria was observed in 3 donors in the first threeweeks. The transplantation operations were performed uneventful in all the 11 recipients. Graft function recovered well in all the re-cipients. Acute rejection occurred in two recipients. The first year patient and graft survivals were both 100%, and one reeipientdied 1.5 year postoperation due to hepatic failure with normal graft function. CONCLUSION Evaluation of both donor and re-cipient,and perioperative care are the key factors to living related renal transplantation. LRRT is advocated in China for its lowerrejection rate and better survival.