Höppner W, Dreikorn K
Urologische Klinik, Zentralkrankenhaus St.-Jürgen-Strasse, Bremen.
Urologe A. 1995 Nov;34(6):485-8.
Mortality rates of 1.2-38% and morbidity rates up to 68% following transplant nephrectomy (TPL-X) have been reported in the literature. From 1988 to 1995, 40 TPL-X were performed in the transplant centre in Bremen. In 15 cases the organs were removed within the first 6 weeks after renal transplantation. The indications were infarction in 10 cases, hyperacute/acute rejection in 3 cases, and repeated rejections with irreversible functional disorder in 2 cases. In the 25 patients in whom TPL-X was performed later than 6 weeks after transplantation the indication was chronic rejection associated with clinical findings in every case. The overall mortality rate was zero in the first 6 weeks after TPL-X, and the morbidity rate, 20%. TPL-X is a re-operation in patients with chronic disease. From this point of view the complication rate with a subtle technique is acceptable. The indications for TPL-X have not been well defined in the literature, so that the decision as to whether or not TPL-X is indicated is made on the basis of the individual situation. TPL-X seems not to be necessary in all cases of transplant failure.
文献报道移植肾切除术后（TPL-X）的死亡率为1.2%-38%，发病率高达68%。1988年至1995年期间，不来梅移植中心进行了40例TPL-X手术。其中15例在肾移植后的前6周内切除了移植肾。其指征为：梗死10例，超急性/急性排斥反应3例，反复排斥反应伴不可逆功能障碍2例。在25例移植后6周后进行TPL-X手术的患者中，指征均为与临床表现相关的慢性排斥反应。TPL-X术后前6周的总死亡率为零，发病率为20%。TPL-X是针对慢性病患者的再次手术。从这一角度来看，采用精细技术时并发症发生率是可以接受的。TPL-X的指征在文献中尚未明确界定，因此是否进行TPL-X手术需根据个体情况决定。并非在所有移植失败的病例中都有必要进行TPL-X手术。
