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成人肾移植的持续非卧床腹膜透析(CAPD)策略。

Continuous ambulatory peritoneal dialysis (CAPD) policy for renal transplantations in adults.

作者信息

Shiramizu T, Satoh T, Jinushi K, Oka N, Inokuchi K

出版信息

Tokai J Exp Clin Med. 1986 Oct;11(4):255-6.

PMID:3303455
Abstract

In Japan CAPD in cases of renal transplantation used to be feared because of CAPD peritonitis occurring under conditions of immunosuppression. We experienced two cases of CAPD with renal transplantation. Case 1 was a 27-year-old woman who underwent living related renal transplantation on March 7, 1986 after 4 months CAPD without CAPD peritonitis. In this patient the CAPD catheter was removed on the 17th POD with a good graft function. Case 2 was a 38-year-old woman who underwent living related renal transplantation on November 8, 1985. The graft deteriorated due to acute rejection and ALG allergy. On February 1, 1986 the graft was removed after insertion of a CAPD catheter. The patient began CAPD. Therefore, CAPD was found to be a safe procedure for renal transplantation. Our policy concerning CAPD for renal transplantation is as follows: A patient should not be transplanted for 1 month after successful treatment of an episode of peritonitis. After renal transplantation the catheter is removed on completion of the transplantation procedure in cases of two haploidentical living related transplants and electively 2-12 weeks after renal transplantation in cases of one haploidentical living related transplant or cadaveric transplants. The CAPD catheter is used again when there is temporary or permanent graft failure.

摘要

在日本,由于腹膜透析性腹膜炎会在免疫抑制状态下发生,所以过去肾移植患者对持续性非卧床腹膜透析(CAPD)心存恐惧。我们经历了两例肾移植患者进行CAPD的情况。病例1是一名27岁女性,在进行了4个月无腹膜透析性腹膜炎的CAPD后,于1986年3月7日接受了亲属活体肾移植。该患者在术后第17天拔除了CAPD导管,移植肾功能良好。病例2是一名38岁女性,于1985年11月8日接受了亲属活体肾移植。由于急性排斥反应和抗淋巴细胞球蛋白过敏,移植肾恶化。1986年2月1日,在插入CAPD导管后切除了移植肾。患者开始进行CAPD。因此,发现CAPD对于肾移植是一种安全的操作。我们关于肾移植CAPD的策略如下:腹膜炎发作成功治疗后1个月内患者不应接受移植。肾移植后,在两次半相合亲属活体移植的情况下,移植手术完成后拔除导管;在一次半相合亲属活体移植或尸体移植的情况下,选择性地在肾移植后2 - 12周拔除导管。当出现临时或永久性移植肾功能衰竭时,再次使用CAPD导管。

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