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Objectives To report the clinical experiences of srmultaneous hepatorenal transplantation.Methods We performed simultaneous hepatorenal transplantation in one patient with liver cirrhosis of hepatitis B and uremia of chronic nephritis on February 1,1999 and one patient with liver cirrhosis of hepatitis B complicated by hepatorenal syndrome on March 12,1999.The donors were heart arrest cases. Rapid multiple organ harvesting techniques and UW solution infusion in situ were used. Liver and kidney transplantation were orthotopic and ordinary methods,respectively. Immunosuppressive drugs consisted of cyclosporine, Cellcept, ALG and sortstso steroids.Lamividine was used os day 50 and day 40postoparation, respectively.Results Both transplanted organs rapidly achieved normal function postoperation and the patients recovered well but suffered mild kidney rejection day 110 postopemtion in No 1 patient. In No 2 patient,acute renal function failure, mental symptoms, muscle spasm,cerebral artery thrombosis, inhalation poeumonia and chronic liver graft rejection ensured sequentially but were controlled.The patients have survived for more than nine and eight months,respectively, with normal life quality.Conclusions Combined hepatorenal transplant is a radical treatment method for liver and kidney function failure and requires more comprehensive techniques than isolated single organ transplantation.Preventing the recurrence of hepatitis B by oral lamividine may be a kdy to long-term survival.
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肾移植术后早期急性肾功能损害救治及存活率临床分析
肾移植受者南于急性排斥、急性肾小管坏死和尿路梗阻等特殊原因可造成移植肾急性肾功能损害(AKI),而且发生AKI的可能性远高于一般人群.移植后早期的基础肾功能对移植肾长期生存有重要的影响,所以AKI的救治成功与否成为影响移植肾长期生存率的突出问题[1].本研究总结奉中心50例术后早期发生移植肾AKI患者的疗效和人、肾长期存活率.
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肾移植受者术后早期尿路感染病原菌及耐药性分析
肾移植患者是接受免疫抑制治疗的特殊人群,术后早期尿路感染的病原菌谱可能与普通尿路感染患者有所不同.为了避免临床滥用抗生素造成病原菌种类变迁加速和诱导耐药菌产生,本研究总结我院肾移植患者术后早期双J管移植肾肾盂端和膀胱端培养的细菌及其耐药情况,从而指导临床合理应用抗生素.