目的:总结和分析86例亲属活体供肾移植的近期并发症和诊治经验。方法:回顾性分析2003年11月～2009年4月86例亲属活体肾移植的临床资料。其中6例为夫妻间供肾,80例为直系血缘亲属供肾。供体均为开放手术取肾,受体首次移植84例,再次移植2例,术后采用环孢素A(或他克莫司)加霉酚酸酯(或硫唑嘌呤)加泼尼松预防排斥反应。结果:86例供体取肾术后7～10天出院,所有供体随访3～12个月,肾功能正常。86例受者中术后发生急性排斥反应8例,均经甲泼尼龙或抗胸腺细胞球蛋白治疗逆转。6例发生术后肺部感染,死亡2例。4例发生移植肾功能延迟恢复,其中1例并发移植肾周血肿合并弥漫性血管内凝血,最后因多器官功能衰竭死亡。术后移植肾周血肿再次手术6例,5例治愈。发生尿瘘6例,经保守治疗痊愈。83例存活者随访至今,其中术后1年发生慢性移植物失功2例,移植肾功能正常81例。结论:活体亲属供肾移植安全、疗效好,术后应高度重视和正确处理并发症,以获得人肾的长期存活。 OBJECTIVE: To summarize and analyze the recent complication and diagnosis and treatment of 86 cases of living donor kidney transplantation. Methods: The clinical data of 86 relatives living donor kidney transplantation from November 2003 to April 2009 were retrospectively analyzed. Among them, 6 cases were for husband and wife and 80 cases were for immediate blood relatives. The donors were enrolled in the open surgery. The recipients were transplanted for the first time in 84 cases and transplanted in 2 cases. The patients were treated with cyclosporin A (or tacrolimus) plus mycophenolate mofetil (or azathioprine) plus prednisone Prevention of rejection. Results: 86 donors were discharged 7 days to 10 days after renal transplantation. All donors were followed up for 3 to 12 months and their renal function was normal. There were 8 cases of acute rejection after operation in 86 cases, all of which were reversed by methylprednisolone or anti-thymocyte globulin. 6 cases of postoperative pulmonary infection, died in 2 cases. In 4 cases, delayed graft function was recovered, of which 1 case had perinephric hematoma complicated with diffuse intravascular coagulation and finally died of multiple organ failure. Postoperative perirenal hematoma transplanted in 6 cases, 5 cases were cured. Urinary fistula occurred in 6 cases, cured by conservative treatment. 83 survivors were followed up till now, including 2 cases of chronic graft loss 1 year after operation and 81 cases of normal graft function. CONCLUSION: Living-related kidney transplantation is safe and effective, and postoperative complications and complications should be given high priority to obtain long-term survival of human kidney.