再次肾移植的临床研究

目的 探讨影响再次肾移植效果的因素。方法 对再次肾移植的４３例患者按术后用药方案的不同分２个组进行回顾性分析。结果 术后急性排斥反应（ＡＲ）的发生率为２７．９％急性肾小管坏死（ＡＴＮ）的发生率为２３．３％，移植后人／肾、１、３、５年存活率分别为８２．４％／６４．７％、７８．３％／６０．９％、６６．７％／５５．５％。环孢素Ａ（ＣｓＡ）组和抗淋巴细胞球蛋白组人／肾１年存活率分别为７７．８％／５５．６％

Clinical study on kidney retransplantation

Objective To explore the factors influencing the effects of kidney retransplantation. Methods 43 recipients with kidney retransplantation were divided into two groups (CsA treated group and ALG treated group) and analyzed retrospectively.Results Acute rejection occurred in 12 patients ( 27.9% ) and acute tubular necrosis in 10 recipients during the first post transplantation month. The total survival rate of patients and grafts in 1, 3, 5 years were 82.4% and 64.7% , 78.3% and 60.9% , and 66.7% and 55.5% , respectively. The survival rate for one year patients and grafts was 77.8% and 55.6% in CsA treated group, and 87.5% and 75% in ALG treated group, respectively.Conclusion Using CsA sequentially can increase the survival rate of the patients and grafts of retransplantation. Nephrectomy of the primary allograft had better be performed in the time of retransplantation. The patients with the lymphocyte response antibody over 50% are not permitted to undergo retransplantation. Plasma exchange will not be used effectively to prevent postoperative acute rejection in the hypersensitive patients.