老年患者的肾移植 (51例临床经验)

目的：探讨老年患者肾移植手术适应证及术后免疫抑制剂的应用特点，提高人／肾存活率。方法：对５１例年龄为６０～８３岁老年肾移植患者进行临床分析，研究手术成功与失败者的经验与教训，探讨供肾者的质量，ＰＲＡ、ＨＬＡ配型，术后免疫抑制应用情况。结果：５１例患者后发生并发症２０例（３９．２％），其中，急性肾小管坏死３例，急性排斥反应６例，ＣｓＡ肝、肾中毒２例，肺部感染５例，心力衰竭３例，脑出血１例。１、３、５

KIDNEY TRANSPLANTATION IN AGED PATIENTS:AN EXPERIENCE IN 51 CASES

To report our experience in 51 cases of renal transplantation in aged recipients and to analyze the risk factors associated with near and long term survivals. METHODOLOGY Fifty one aged recipients(age at operation,60-83 years old)accepted cadaveric renal allografts between 1978 and 2000.A retrospective analysis was made in these 51 cases with respect to the immunesuppresive regimes,near term complications,and long term survivals. RESULTS 20 of the 51 patients(39 2%)had post-operation complications,including acute tubular necrosis in 3,acute rejection in 6,lung infections in 5,cyclosporine A toxicity in 2,heart failure in 3,and intracerebral hemorrhage in 1 patient.The patient survivals and graft survivals were 92 2% and 90 2% at the end of the first year,88 2% and 86 3% the third year,82 4% and 80 4% the 5 th year respectively. CONCLUSION In the kidney transplantation in aged patients,attentions should be paid to graft matching and graft quality,perioperation complications,and proper immuno-suppressive regimes.