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Compare and Analysis the Clinical Results between Living Related Donor and Cadaveric Donor Renal Transplantation

Author: CaiZhiTao
Tutor: LiHeng;ZengFuQing
School: Huazhong University of Science and Technology
Course: Surgery
Keywords: Kidney transplant Living donors Clinical efficacy Lung infection
CLC: R699.2
Type: Master's thesis
Year: 2008
Downloads: 55
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Abstract


The first part of relatives living donor kidney transplantation with corpses after kidney transplantation living related donor kidney transplantation with corpses for renal transplant clinical comparison with the same period of comparison and analysis of the purpose of the analysis of clinical efficacy after. Methods A retrospective analysis of 26 cases of living related donor kidney transplant donors, recipients of the clinical data and the same period, 92 cases of cadaveric renal transplantation clinical data were analyzed to compare postoperative renal recovery effect, after a cyclosporine dosage in the month, the year after surgery, acute rejection incidence of pulmonary infection rates after one month, three months, six months, one year, two years renal function (serum creatinine), patient / graft survival. Results 26 cases of relatives living donor had no surgical complications, postoperative renal function is normal, unaffected life and work. Recipients after renal recovery speed: living-donor kidney group of 286.11 ± 81.33μmol / (L.day), a cadaveric kidney group was 136.63 ± 78.79μmol / (L.day) (P lt; 0.01); postoperative recovery of renal function best value: living related donor kidney group 83.24 ± 20.91μmol / L, cadaveric donor kidney group is 108.23 ± 28.56μmol / L (P lt; 0.01); within one month after cyclosporine dosage: relatives living donor donor kidney group was 5.87 ± 0.82 mg / kg / day, cadaveric donor kidney group was 7.49 ± 1.12mg/kg/day (P lt; 0.05); living related donor kidney transplantation with cadaveric renal transplant recipients within one year acute rejection were 3.85% and 28.26% (P lt; 0.05); lung infection rates were 7.69% and 31.52% (P lt; 0.05); postoperative month, three months, six months, one year, two year / graft survival: living related donor kidney group was 100% / 100%, 96.15% / 96.15%, 92.31% / 92.31%, 92.31% / 92.31%, 88.46% / 88.46% cadaveric donor kidney group to 91.30 % / 84.78%, 89.13% / 82.61%, 84.78% / 78.26%, 82.61% / 76.09%, 81.52% / 72.83% (P lt; 0.05); renal function (serum creatinine): relatives living donor kidney group was 92.4 ± 13.2 (μmol / L), 95.6 ± 13.7 (μmol / L), 98.2 ± 15.4 (μmol / L), 113.2 ± 17.8 (μmol / L), 131.2 ± 19.3 (μmol / L), cadaveric donor kidney group was 109.4 ± 16.7 (μmol / L), 114.5 ± 18.2 (μmol / L), 119.3 ± 19.1 (μmol / L), 122.5 ± 18.3 (μmol / L), 138.6 ± 21.3 (μmol / L) (P lt; 0.05). Conclusion carried out at the same relatives living donor kidney transplantation postoperative renal function recovery / graft survival are better than deceased donor kidney transplantation, the amount of postoperative immunosuppressants, acute rejection reaction and pulmonary infection rate is also lower than the corpse for renal transplantation. In short, the relatives live donor kidney transplant recipients clinically superior deceased donor kidney transplantation is safe and effective in clinical. The second part of renal transplantation causes and treatment of severe pulmonary infection Objective: To investigate the causes and treatment of renal transplant complications after severe lung infection. Methods: A retrospective analysis of 29 cases of clinical data of patients with severe pulmonary infection after renal transplantation. Results: 29 patients with simple infections: bacterial infection in 2 patients, and Mycobacterium tuberculosis infection in 2 cases, 3 cases of fungal infection, cytomegalovirus infection, 2 cases; 14 cases of mixed infection, not identify pathogens six cases, occurred in the postoperative six months. 17 patients (58.6%) of severe pulmonary infection in patients with successful treatment, 12 patients (41.4%) died due to acute respiratory distress syndrome. Conclusion: six months after renal transplantation is a high incidence of severe pulmonary infection with occult onset, rapid development, the complexity of the disease dangerous, intractable, costly, and high mortality, should be given high priority and where the active given early enough amount of broad-spectrum antibiotics and drug combination anti-infection treatment and clear etiological diagnosis, to decisively reduce or disable immunosuppressants, and actively correct hypoxemia and hypoproteinemia key is successfully treated.

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CLC: > Medicine, health > Surgery > Urology ( urinary and reproductive system diseases) > Urinary tract and male reproductive system surgery > Kidney surgery
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