中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2011年
5期
272-275
,共4页
魏来%陈知水%曾凡军%明长生%陈忠华%刘敦贵%刘斌%宫念樵%蒋继贫%杜敦峰
魏來%陳知水%曾凡軍%明長生%陳忠華%劉敦貴%劉斌%宮唸樵%蔣繼貧%杜敦峰
위래%진지수%증범군%명장생%진충화%류돈귀%류빈%궁념초%장계빈%두돈봉
肝肾联合移植%肝肾综合征
肝腎聯閤移植%肝腎綜閤徵
간신연합이식%간신종합정
Combined liver and kidney transplantation%Hepatorenal syndrome
目的 分析单中心肝肾联合移植(SLKT)的治疗效果.方法 1999-2010年间共实施SLKT 21例,患者的原发疾病分别为多囊病11例,病毒性肝炎后肝硬化合并肝肾综合征5例,慢性肾炎肾功能衰竭合并肝硬化2例,肾移植术后移植肾功能丧失合并肝硬化2例,肝炎后肝硬化合并糖尿病肾病1例.统计患者的资料,与同期同中心"中国肝移植注册网站"收录的肝炎后肝硬化行肝移植的133例(LT组)和"中国肾移植科学登记系统"收录的尸体肾移植609例(KT组)进行对比,分析各组受者术前状态和预后的差异.结果 SLKT组术前终末期肝病模型(MELD)评分为21.3±5.5,血肌酐为(516.0±329.9)mmol/L;LT组术前MELD评分为20.6±9.9,血肌酐为(111.4±138.1)mmol/L,与SLKT组相比较,血肌酐的差异有统计学意义(P＜0.01).SLKT组中,3例分别于术后2周、半年和5年因感染而死亡,1例因多器官功能衰竭而死亡,1例于术后5年自行停药,因排斥反应而死亡.SLKT组术后1年内移植肾急性排斥反应的发生率为零,KT组为6 %(P＞0.05).术后SLKT组移植肾功能延迟恢复的发生率为9.5 %,KT组为17.3 %(P＞0.05).SLKT组术后1、3和5年的受者存活率分别为87.7 %、67.8 %和67.8 %,LT组分别为84.2 %、73.5 %和69.4 %(P＞0.05).结论 SLKT是终末期肝、肾疾病的有效、安全的治疗方法.
目的 分析單中心肝腎聯閤移植(SLKT)的治療效果.方法 1999-2010年間共實施SLKT 21例,患者的原髮疾病分彆為多囊病11例,病毒性肝炎後肝硬化閤併肝腎綜閤徵5例,慢性腎炎腎功能衰竭閤併肝硬化2例,腎移植術後移植腎功能喪失閤併肝硬化2例,肝炎後肝硬化閤併糖尿病腎病1例.統計患者的資料,與同期同中心"中國肝移植註冊網站"收錄的肝炎後肝硬化行肝移植的133例(LT組)和"中國腎移植科學登記繫統"收錄的尸體腎移植609例(KT組)進行對比,分析各組受者術前狀態和預後的差異.結果 SLKT組術前終末期肝病模型(MELD)評分為21.3±5.5,血肌酐為(516.0±329.9)mmol/L;LT組術前MELD評分為20.6±9.9,血肌酐為(111.4±138.1)mmol/L,與SLKT組相比較,血肌酐的差異有統計學意義(P＜0.01).SLKT組中,3例分彆于術後2週、半年和5年因感染而死亡,1例因多器官功能衰竭而死亡,1例于術後5年自行停藥,因排斥反應而死亡.SLKT組術後1年內移植腎急性排斥反應的髮生率為零,KT組為6 %(P＞0.05).術後SLKT組移植腎功能延遲恢複的髮生率為9.5 %,KT組為17.3 %(P＞0.05).SLKT組術後1、3和5年的受者存活率分彆為87.7 %、67.8 %和67.8 %,LT組分彆為84.2 %、73.5 %和69.4 %(P＞0.05).結論 SLKT是終末期肝、腎疾病的有效、安全的治療方法.
목적 분석단중심간신연합이식(SLKT)적치료효과.방법 1999-2010년간공실시SLKT 21례,환자적원발질병분별위다낭병11례,병독성간염후간경화합병간신종합정5례,만성신염신공능쇠갈합병간경화2례,신이식술후이식신공능상실합병간경화2례,간염후간경화합병당뇨병신병1례.통계환자적자료,여동기동중심"중국간이식주책망참"수록적간염후간경화행간이식적133례(LT조)화"중국신이식과학등기계통"수록적시체신이식609례(KT조)진행대비,분석각조수자술전상태화예후적차이.결과 SLKT조술전종말기간병모형(MELD)평분위21.3±5.5,혈기항위(516.0±329.9)mmol/L;LT조술전MELD평분위20.6±9.9,혈기항위(111.4±138.1)mmol/L,여SLKT조상비교,혈기항적차이유통계학의의(P＜0.01).SLKT조중,3례분별우술후2주、반년화5년인감염이사망,1례인다기관공능쇠갈이사망,1례우술후5년자행정약,인배척반응이사망.SLKT조술후1년내이식신급성배척반응적발생솔위령,KT조위6 %(P＞0.05).술후SLKT조이식신공능연지회복적발생솔위9.5 %,KT조위17.3 %(P＞0.05).SLKT조술후1、3화5년적수자존활솔분별위87.7 %、67.8 %화67.8 %,LT조분별위84.2 %、73.5 %화69.4 %(P＞0.05).결론 SLKT시종말기간、신질병적유효、안전적치료방법.
Objective To analyze the curative effect of simultaneous liver and kidney transplantation (SLKT) for patients with end-stage liver and kidney diseases and liver cirrhosis patients with hepatorenal syndrome.Methods All SLKTs (n=21) performed at our center from January 1999 to December 2010 were reviewed and SLKT outcomes were compared with those of kidney transplantation (KT) (n=609) and liver transplantation (LT) (n=133) performed during the same period.Results There were 3 deaths due to infection 2 weeks, 6 months and 5 years respectively after operation. One patient died due to multiple organ dysfunction syndrome 2 weeks after operation. One patient was dead 5 years after operation because of rejection. MELD level between SLKT and LT had no significant difference, but serum creatinine in SLKT group was significantly higher than in LT group (516.0±329.9 vs 111.4±138.1 mmol/L, P<0.01). The 1-year acute kidney rejection rate and rate of delayed graft function (DGF) of the kidney had no significant difference between SLKT group (0 vs 9.5 %) and KT group (6 % vs 17.3 %). There was no significant difference in one-, 3- and 5-year patient survival rate between SLKT group (87.7 %, 67.8 % and 67.8 %) and LT group (84.2 %, 73.5 % and 69.4 %).Conclusion SLKT is a safe and effective treatment for end-stage liver and kidney diseases.
