摘要
目的探讨70岁以上老年供肾活体肾移植的临床疗效。方法以2017年9月至2019年6月中国科技大学附属第一医院(安徽省立医院)肾移植科18例供者年龄超过70岁的活体肾移植供、受者为研究对象,收集围手术期临床资料和随访数据,根据单侧供肾肾小球滤过率(GFR)是否低于40 ml/(min·1.73 m^(2))分为低供肾GFR组(8例)和正常供肾GFR组(10例),分别对两组血肌酐和移植肾存活率等参数进行统计学分析。同时回顾性分析术后并发症等随访结果。结果18例供、受者均手术顺利,未发生严重围手术期并发症和二次手术;受者术后未发生移植物功能延迟,围手术期出现急性排斥反应1例(5.6%),术后第3天平均血肌酐(155.7±63.5)μmol/L,出院时血肌酐(97.6±28.7)μmol/L;随访时间37.5个月(27~48个月),18例供者术后恢复顺利,随访期间健康状况良好,未发生蛋白尿、供肾手术相关住院或死亡,出院血肌酐(86.8±18.3)μmol/L,末次随访血肌酐(84.4±15.0)μmol/L,两组差异无统计学意义(P=0.610);18例受者随访期间受者、移植肾存活率均为100%,随访第12个月、第24个月和末次随访血肌酐分别为(92.1±18.3)μmol/L、(95.5±21.9)μmol/L和(100.1±21.2)μmol/L,三组比较差异无统计学意义(P=0.507);18例受者发生蛋白尿3例(16.7%),移植肾功能均稳定;18例供肾中有8例(44.4%)肾小球滤过率低于40 ml/(min·1.73m^(2)),该8例供肾的移植受者术后第3天、出院时以及各随访点血肌酐水平与其他10例比较,差异均无统计学意义(P>0.05)。结论70岁以上老年供肾活体肾移植短、中期疗效良好,供、受者经严格评估后可以手术,远期效果有待进一步观察。
Objective To explore the clinical efficacy of kidney transplantation(KT)from senile living-related donors aged over 70 years.Methods Between 2017 and 2019,perioperative and follow-up data from 18 pairs of donors and recipients were retrospectively reviewed.Results Operations of all 18 pairs of recipients and donors were conducted successfully without serious perioperative complications.No delayed graft function occurred.There was 1 episode(5.6%)of acute rejection.The mean level of serum creatinine(SCr)at Day 3 post-KT and at discharge was(155.7±63.5)and(97.6±28.7)μmol/L.The median follow-up period was 37.5 months.All 18 donors survived with normal renal function.And no proteinuria or kidney donation related hospitalization events occurred.SCr was(84.4±15.0)μmol/L at the last follow-up and there was no statistical significance as compared with SCr level at discharge(P=0.610).No recipient mortality or graft loss occurred.Levels of SCr were(92.1±18.3),(95.5±21.9)and(100.1±21.2)μmol/L at Month 12/24 and the last follow-up.No statistical difference existed in posttransplant SCr level at these follow-up timepoints(P=0.507).Posttransplant proteinuria occurred in 3 recipients(16.7%).In 8 donors,donated kidney glomerular filtration rate(GFR)was lower than 40 ml/(min·1.73m^(2)).No statistical difference existed in posttransplant SCr level between this group and higher GFR group(P>0.05).Conclusions After thorough preoperative assessments,satisfactory short-term outcomes may be achieved for KT from living-related donors aged over 70 years.The long-term outcome should be further explored.
作者
刘洪涛
张乐希
潘国政
李势辉
叶剑锋
邱成
潘大庆
戴帅
Liu Hongtao;Zhang Lexi;Pan Guozheng;Li Shihui;Ye Jianfeng;Qiu Cheng;Pan Daqing;Dai Shuai(Department of Kidney Transplantation,First Affiliated Hospital,University of Science and Technology of China,Anhui Provincial Hospital,Hefei 2030036,China)
出处
《中华器官移植杂志》
CAS
2022年第3期146-150,共5页
Chinese Journal of Organ Transplantation
关键词
肾移植
老年供肾
活体肾移植
Kidney transplantation
Olderly donated kidney
Living kidney transplantation
