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亲属活体肾移植的长期结果:对114例接受者进行10年以上随访的回顾性研究。

Long-term results of living related kidney transplantation: a retrospective study on 114 recipients followed over 10 years.

作者信息

Yasumura T, Oka T, Omori Y, Nakane Y

机构信息

Second Department of Surgery, Kyoto Prefectural University of Medicine, Japan.

出版信息

Jpn J Surg. 1991 Mar;21(2):138-44. doi: 10.1007/BF02470900.

DOI:10.1007/BF02470900
PMID:2051658
Abstract

The long-term patient and graft survivals, causes of death, complications and rehabilitation status in the second decade were analyzed in 114 patients who received living related kidney transplants and were followed up for 10 years or longer. Azathioprine and prednisolone were used for basal immunosuppressive therapy in all patients. The actual patient and graft survival rates at 10 years were 76.3 per cent and 50.9 per cent respectively, the main causes of death being serious infection (10 cases), malignant disease (5 cases), cerebral bleeding (4 cases), hepatic failure (3 cases), gastrointestinal bleeding (2 cases) and cardiovascular disorder (2 cases). Four patients died from complications after re-admission for hemodialysis. The cumulative patient and graft survival rates at 15 years in 58 patients whose graft survived for over 10 years were 87 per cent and 75 per cent, respectively. Of the 51 patients still surviving at the end of the study, the complete rehabilitation rate was 90.2 per cent, however, de novo malignant disease and hepatic disorder were significant complications which not only disturbed the patients' quality of life but also reduced their survival rate. Therefore, regular follow-up of patients and appropriate management procedures are necessary to enhance the long-term success of kidney transplantation.

摘要

对114例接受亲属活体肾移植并随访10年及以上的患者,分析了其第二个十年的长期患者和移植物存活率、死亡原因、并发症及康复状况。所有患者均使用硫唑嘌呤和泼尼松龙进行基础免疫抑制治疗。10年时患者和移植物的实际存活率分别为76.3%和50.9%,主要死亡原因包括严重感染(10例)、恶性疾病(5例)、脑出血(4例)、肝衰竭(3例)、胃肠道出血(2例)和心血管疾病(2例)。4例患者因再次入院进行血液透析后出现并发症死亡。58例移植物存活超过10年的患者15年时的累积患者和移植物存活率分别为87%和75%。在研究结束时仍存活的51例患者中,完全康复率为90.2%,然而,新发恶性疾病和肝脏疾病是严重并发症,不仅影响患者生活质量,还降低其存活率。因此,对患者进行定期随访并采取适当的管理措施对于提高肾移植的长期成功率是必要的。

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引用本文的文献

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Curr Ther Res Clin Exp. 2006 Mar;67(2):103-17. doi: 10.1016/j.curtheres.2006.04.005.

本文引用的文献

1
Chronic hepatitis in end-stage renal disease: comparison of HBsAg-negative and HBsAg-positive patients.
Kidney Int. 1985 Dec;28(6):959-67. doi: 10.1038/ki.1985.224.
2
Study of 172 patients at 10 to 21 years after renal transplantation.对172例肾移植术后10至21年患者的研究。
Transplant Proc. 1987 Oct;19(5):3769-71.
3
Long-term results in kidney transplantation: patient and graft survival, causes of graft failure and mortality, renal function and complications after 10 years.肾移植的长期结果:患者及移植物存活情况、移植物失败及死亡原因、10年后的肾功能及并发症
Transplant Proc. 1987 Oct;19(5):3767-8.
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Long-term prognosis of renal transplantation: a retrospective study of 90 patients living more than 10 years with a functioning allograft.肾移植的长期预后:对90例同种异体移植肾功能存活超过10年患者的回顾性研究。
Transplant Proc. 1987 Oct;19(5):3765-6.
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Late mortality and morbidity at 5 to 18 years after kidney transplantation.肾移植术后5至18年的晚期死亡率和发病率。
Transplant Proc. 1987 Oct;19(5):3760-1.
6
Long-term results and complications in renal transplant recipients. Observations in the second decade.肾移植受者的长期结果及并发症。第二个十年的观察情况。
Transplantation. 1988 Jan;45(1):45-52. doi: 10.1097/00007890-198801000-00011.
7
Long-term survivors of kidney transplantation, mortality, rehabilitation, and immunologic reactivities.肾移植长期存活者、死亡率、康复及免疫反应性
Transplant Proc. 1987 Feb;19(1 Pt 3):2120-1.
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Development of malignancies in Japanese renal transplant recipients.日本肾移植受者恶性肿瘤的发生情况
Transplant Proc. 1987 Apr;19(2):2967-70.
9
Long term results and complications of transplantation: the kidney.移植的长期结果与并发症:肾脏
Transplant Proc. 1989 Feb;21(1 Pt 2):1433-4.
10
The incidence of malignancies in transplant recipients.移植受者中恶性肿瘤的发病率。
Transplant Proc. 1975 Jun;7(2):323-6.