中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (5): 947-950.doi: 10.3969/j.issn.1673-8225.2012.05.044

• 器官移植综述 organ transplantation review • 上一篇    

肾移植后血管并发症介入治疗8例*☆

李金锋1，丰贵文1，管  生2，丁鹏绪2，王　跃1，庞新路1，尚文俊1，刘  磊1   

  1. 郑州大学第一附属医院，1肾移植科，2放射介入科，河南省郑州市  450052
  • 收稿日期:2011-11-16 修回日期:2011-12-10 出版日期:2012-01-29 发布日期:2012-01-29
  • 通讯作者: 丰贵文，博士，副主任医师，郑州大学第一附属医院肾移植科，河南省郑州市 450052 fengguiwen123@126.com
  • 作者简介:李金锋☆，男，1980年生，河南省延津县人，汉族，2009年复旦大学毕业，博士，主治医师，主要从事肾移植研究。 jinfenglis512@126.com
  • 基金资助:

    郑州大学第一附属医院青年基金资助项目(2011-QN010)。

Interventional treatment for vascular complications after kidney transplantation in eight cases 

Li Jin-feng1, Feng Gui-wen1, Guan Sheng2, Ding Peng-xu2, Wang Yue1, Pang Xin-lu1, Shang Wen-jun1, Liu Lei1   

  1. 1Department of Kidney Transplantation, 2Department of Intervention and Radiation, First Affiliated Hospital of Zhengzhou University, Zhengzhou  450052, Henan Province, China
  • Received:2011-11-16 Revised:2011-12-10 Online:2012-01-29 Published:2012-01-29
  • Contact: Feng Gui-wen, Doctor, Associate chief physician, Department of Kidney Transplantation, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China Fengguiwen123@126.com
  • About author:Li Jin-feng☆, Doctor, Attending physician, Department of Kidney Transplantation, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China Jinfenglis512@126.com
  • Supported by:

    Foundation for the Youth of the First Affiliated Hospital of Zhengzhou University, No.2011-QN010*

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摘要：

背景：肾移植后血管并发症采用介入治疗已成为一种安全有效的治疗方法。
目的：探讨肾移植后血管并发症介入治疗的经验及价值评估。
方法：回顾性分析8例肾移植后血管并发症患者介入治疗的临床资料。
结果与结论：8例移植后5例肾移植肾动脉狭窄，2例假性动脉瘤，1例肾静脉血栓，均经彩色多普勒血流显像作出初步诊断，其中5例进一步行磁共振血管成像明确诊断。5例移植肾动脉狭窄行球囊扩张，分别随访6，8，20，36，40个月，1例出现再狭窄，随访血肌酐维持在130~160 μmol/L之间，其余4例移植肾狭窄无复发，随访血肌酐均正常。2例假性动脉瘤患者经动脉鞘放入支架释放系统释放带膜支架后动脉瘤消失，目前常规血液透析治疗。1例肾静脉血栓形成患者，尿激酶介入溶栓治疗后血栓消失，患者发生移植肾功能延迟恢复，35 d后血肌酐降至210 μmol/L，此后患者血肌酐维持在200~250 μmol/L。8例介入治疗临床效果说明肾移植后血管并发症治疗可选用介入治疗方法。
关键词：血管并发症；介入治疗；肾移植；肌酐；器官移植
doi:10.3969/j.issn.1673-8225.2012.05.044

关键词: 血管并发症, 介入治疗, 肾移植, 肌酐, 器官移植

Abstract:

BACKGROUND: Interventional therapy for vascular complications after allograft kidney transplantation has become a safe and effective treatment.
OBJECTIVE: To explore the diagnosis experiences and value evaluation of interventional treatment for vascular complications after allograft kidney transplantation.
METHODS: The clinical data of eight patients with interventional treatment for vascular complications after allograft kidney transplantation were retrospectively studied.
RESULTS AND CONCLUSION: In the eight cases undergoing transplantation, five cases were found renal artery stenosis, two cases were found pseudoaneurysm, and one case was found renal vein thrombosis, and they were all diagnosed by color Doppler flow imaging. Five cases of renal artery stenosis took further examination by magnetic resonance angiography, and they underwent ballon angioplasty and followed-up for 6, 8, 20, 36 and 40 months. One case was found restenosis in five cases, whose serum creatinine level maintained in the range of 130-160 μmol/L. Four cases of renal artery stenosis in five cases were found no recurrence, and their serum creatinine level was in normal range. The aneurism in two cases of renal artery pseudoaneurysm disappeared after undergoing stent graft placement across the external iliac artery, and then they were treated with routine hemodialysis. Thrombosis disappeared in one case of renal vein thrombosis after undergoing interventional thrombolysis. The graft function recovery of this case delayed, the serum creatinine level decreased to 210 μmol/L at day 35. After that the serum creatinine level of this case maintained in the range of 200-250 μmol/L. Based on the clinical data of these eight cases, it suggests that interventional treatment for vascular complications after allograft kidney transplantation is feasible.

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