Renal Transplantation at a Medical Center in Taiwan

台灣某醫學中心的腎臟移植經驗

葉進仲(Chin-Chung Yeh) ； 楊慶鏘(Chin-Chiang Yang) ； 陳建州(Chien-Chou Chen) ； 高銘聰(Ming-Tsung Kao) ； 黃春明(Chung-Ming Huang) ； 周昌德(Chung-Tei Cho) ； 張萬森(Wan-Sen Chang) ； 陳汶吉(Wen-Gii Chen) ； 張士三(Shih-San Chang) ； 呂學甫(Hsueh-Fu Lu) ； 吳錫金(Hsi-Chin Wu)

《Mid-Taiwan Journal of Medicine》 4卷2期 (1999/06) Pp. 121-128

https://doi.org/10.6558/MTJM.1999.4(2).8

摘要

本研究的目的是評估1992年至1998年本院腎臟移植的結果。此期間共有22個病人在本院接受腎臟移植，其腎臟來源包括3個活體腎及來自11個屍體的19個屍體腎。活體腎於取出後再灌溉，屍體腎則在原位灌洗。受腎者年齡16至61歲，平均37歲；屍體捐腎者年齡8至40歲，平均23.9歲；活體捐腎者年齡45至61歲，平均51.7歲。受腎者22人中，9個為男性，13個為女性。腎臟移植前的透析為10個接受腹膜透析，12個接受血液透析。他們的血型分佈為A有3個，B有6個，O有11個，AB有2個。腎臟移植後合併症計有尿漏1例、淋巴漏1例、IgA腎臟病變1例、巨細胞病毒感染1例、單純泡疹病毒感染2例、急性腎臟衰竭2例及移植腎動脈狹窄1例。後者經血管攝影證實並經血管內擴張術治療。惡性腫瘤有淋巴癌併發骨骼轉移1例。免疫方面，有1病患在移植後18個月後因慢性排斥而引起腎臟衰竭，另1病患在移植後3個月因急性排斥而接受移植腎摘除手術。死亡病例有4個，包括手術後敗血症1例、腎臟移植37個月後因惡性淋巴癌1例、腎臟移植4個月後因猛爆性肝炎及消化道出血1例及腎臟移植22個月後因敗血症死亡1例。存活率方面則3個月腎存活率為百分之95.2%，病人存活率為95.2%；而1年腎存活率為81.3%，病人存活率為87.5%；3年腎存活率為81.8%，病人存活率為90.9%。

關鍵字

移植腎摘除 ； 淋巴漏 ； 排斥 ； 腎臟移植 ； 尿漏

並列摘要

The purpose of this study was to evaluate the results of renal transplantations performed at our hospital from 1992 through 1998. A total of 22 renal transplantations were performed during this period, while the sources of kidneys included three living donors and 11 cadavers. The kidneys from the living donors were instillated after nephrectomy. The kidneys from cadaver donors were instillated in situ. The gender ratio of recipients was 13 females to nine males. The types of dialysis before transplantation were 12 with hemodialysis and 10 with continuous ambulance peritoneal dialysis (CAPD). The blood types of recipients were three with type A, six with type B, 11 with type O and two with type AB. The complications after transplantation included urinary leakage (n=1), lymph leakage (n=1), IgA nephropathy (n=1), cytomegalovirus infection (n=1), herpes simplex virus infection (n=2), acute renal failure (n=2) and graft renal artery stenosis (n=1). The patient with graft renal artery stenosis was diagnosed using angiography and treated with percutaneous transluminal angioplasty (PTA). Two patients experienced rejection, one had acute rejection and received graft nephrectomy about three months after the transplantation, the other had a nonfunctioning graft due to chronic rejection about 18 months after the transplantation. Four of the patients in this study died. The causes of death included sepsis in two patients, malignant lymphoma with bony metastasis in one and fulminant hepatitis associated with upper gastrointestinal bleeding in one. The survival rates at 3 months after transplantation were 95.2% for the grafts and 95.2% for the patients; those at 1 year were 81.3% for the grafts and 87.5% for the patients and those at 3 years were 81.8% for the grafts and 90.9% for the patients.

並列關鍵字

graft nephrectomy ； lymph leak ； rejection ； renal transplantation ； urinary leak