南方医科大学学报

南方医科大学学报 ›› 2023, Vol. 43 ›› Issue (1): 133-138.doi: 10.12122/j.issn.1673-4254.2023.01.19

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135例肾移植受者移植物丢失的原因分析

刘炎忠，柏宏伟，钱叶勇，李 超，肖 璐，朱 润   

  1. 中国人民解放军总医院第三医学中心泌尿外科医学部，中心麻醉手术室，北京 100039；中国人民解放军总医院第八医学中心泌尿外科，北京 100091
  • 出版日期:2023-01-20 发布日期:2023-02-22

Analysis of causes of graft loss in 135 kidney transplant recipients

LIU Yanzhong, BAI Hongwei, QIAN Yeyong, LI Chao, XIAO Lu, ZHU Run   

  1. Department of Urology, Department of Anesthesia and Surgery, Third Medical Center, Chinese PLA General Hospital, Beijing 100039, China; Department of Urology, Eighth Medical Center, Chinese PLA General Hospital, Beijing 100091, China
  • Online:2023-01-20 Published:2023-02-22

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摘要： 目的 探讨肾移植术后受者移植肾丢失的原因。方法 回顾性分析 2002年1月1日~2022 年1月1日在中国人民解放军总医院第八医学中心肾移植术后移植物发生丢失的135例受者临床资料。结果 受者移植肾丢失135例，移植肾丢失原因包括排斥反应70例（51.8%）、受者带功能死亡37例（27.4%）、外科并发症12例（8.9%）、药物毒性4例（3.0%）、耐碳青霉烯肺炎克雷伯菌感染4例（3.0%）、多瘤病毒相关性肾病3例（2.2%）、原发性无功能肾2例（1.5%）、原发病复发2例（1.5%）、肾前性急性肾衰1例（0.7%）。结论 肾移植术后受者移植物丢失原因主要原因是排斥反应，次要原因是受者带功能死亡，其他原因少见。

关键词: 肾移植；移植肾丢失；排斥反应；受者带功能死亡

Abstract: Objective To investigate the causes of graft loss in kidney transplant recipients. Methods We retrospectively analyzed the clinical data of 135 recipients with graft loss after renal transplantation in the Eighth Medical Center of Chinese PLA General Hospital from January 1, 2002 to January 1, 2022. Results A total of 135 kidney transplant recipients experienced graft failure. The causes of graft loss included graft rejection (70 cases, 51.8%), death of the recipients with functional graft (37 cases, 27.4%), surgical complications (12 cases, 8.9%), drug toxicity (4 cases, 3.0%), carbapenem-resistant Klebsiella pneumoniae infection (4 cases, 3.0% ), polyoma BK virus-related nephropathy (3 cases, 2.2% ), primary nonfunctioning kidney (2 cases,1.5% ), recurrence of primary disease (2 cases, 1.5% ), and prerenal acute renal failure (1 case, 0.7% ) . Conclusion The main cause of graft loss after renal transplantation is graft rejection, and the secondary cause is death of the recipient with functional graft, and other reasons can be rare.

Key words: kidney transplantation; allograft loss; graft rejection; kidney recipients with functional graft