中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (44): 8214-8216.doi: 10.3969/j.issn.1673-8225.2011.44.012

• 肾移植 kidney transplantation • 上一篇    下一篇

夫妻间活体供肾移植

王  凯，曲青山，苗书斋   

  1. 郑州人民医院器官移植科，河南省郑州市  450003
  • 收稿日期:2011-05-19 修回日期:2011-06-27 出版日期:2011-10-29 发布日期:2011-10-29
  • 作者简介:王凯★，男，1982年生，河南省开封市人，汉族，2008年郑州大学毕业，硕士，主治医师，主要从事器官移植方向的研究。 hywangkai@126.com

Living unrelated donor kidney transplantation between spouses

Wang Kai, Qu Qing-shan, Miao Shu-zhai   

  1. Department of Organ Transplantation, People’s Hospital of Zhengzhou, Zhengzhou  450003, Henan Province, China
  • Received:2011-05-19 Revised:2011-06-27 Online:2011-10-29 Published:2011-10-29
  • About author:Wang Kai★, Master, Attending physician, Department of Organ Transplantation, People’s Hospital of Zhengzhou, Zhengzhou 450003, Henan Province, China hywangkai@126.com

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388

被引次数

4

摘要：

背景：近几年随着各项移植法规相继出台，中国做为器官移植大国，发展迅速，除了尸体肾移植外，活体肾移植亦得到健康快速发展，夫妻供肾做为没有直接血缘关系的活体移植，在器官移植界占据着重要地位。
目的：观察夫妻间供肾亲属活体肾移植的疗效。
方法：郑州人民医院器官移植科2008-10/2010-09进行夫妻间供肾移植11例，同期尸体供肾肾移植83例为对照组。两组受者均采用供肾静脉与髂外静脉端侧吻合，供肾动脉与髂内动脉端端吻合，输尿管-膀胱乳头式吻合，隧道包埋。免疫抑制诱导方案采用甲基泼尼松龙，基础免疫抑制采用钙调磷酸酶抑制剂(他克莫司或环孢素)、吗替麦考酚酯、肾上腺皮质激素(激素)三联免疫治疗，根据血药谷浓度调整他克莫司或环孢素的用量。移植后6个月内进行随访，评价两组受者移植后的肾功能恢复及早期并发症发生情况。
结果与结论：肾移植后两组急性排斥反应、移植物功能延迟恢复等早期并发症发生率比较，夫妻肾移植组优于尸体肾移植组，差异有显著性意义(P < 0.05)。结果提示夫妻间肾移植由于移植前准备充分，肾脏缺血时间短及夫妻间长期共同生活产生相应的免疫耐受，其疗效优于同样无血缘关系的尸体供肾移植。

关键词: 夫妻间, 活体供肾, 肾移植, 排斥反应, 肾功能

Abstract:

BACKGROUND: In recent years, with emergence of laws and regulations of organ transplantation one after another, rapid advance in organ transplantation has been made in China. In addition to cadaveric renal transplantation, the living donor kidney transplantation has been developed. Living unrelated donor kidney transplantation between spouses occupies an important position in the field of organ transplantation.
OBJECTIVE: To observe the curative effects of living unrelated donor kidney transplantation between spouses.
METHODS: 11 cases who received living unrelated donor kidney transplantation between spouses between October 2008 and September 2010 at Department of Organ Transplantation in People’s Hospital of Zhengzhou and 83 cases who concurrently received cadaveric renal transplantation were included in this study. In each group, the recipients received end-to-side anastomosis between donor renal vein and external iliac vein, end-to-end anastomosis between donor renal artery and internal iliac artery, nipple-like anastomosis between ureter and bladder, and tunnel embedding. The immunosuppressive induction scheme included methyllprednisolone and the triple-drug immunosuppressive therapy consisting of calcineurin (tacrolimus or ciclosporin), mycophenolate mofetil, and adrenal cortical hormone was used as basic immunosuppressive scheme. Trough concentration of drug-containing blood was adjusted according to tacrolimus or ciclosporin application dose. Follow up was performed within 6 months after transplantation. Renal function recovery and complications during the early stage after renal transplantation were evaluated.
RESULTS AND CONCLUSION: Incidence of early complications including acute rejections and delayed function recovery of transplant was significantly lower in cases who received living unrelated donor kidney transplantation between spouses than in cases who received cadaveric renal transplantation (P < 0.05). These results indicate that living unrelated donor kidney transplantation between spouses is superior to cadaveric renal transplantation due to sufficient pre-operative preparation, short renal ischemia time, and corresponding immunological tolerance caused by long-term symbiosis between spouses.

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