无透析肾移植
无透析肾移植
医学博士 Mikel Prieto 讨论无透析肾移植。
开始您的供体评估
单击此处填写病史问卷，开始活体肾脏或肝脏供体评估。
无透析肾移植是指在肾功能恶化到需要透析以代替正常的肾过滤功能之前接受肾移植。
目前，大多数肾移植都在透析患者身上进行，因为他们的肾脏无法继续充分清除血液中的杂质。
无透析肾移植被视为治疗终末期肾病的首选方法，但在美国进行的肾移植手术中仅有约 20% 为无透析肾移植。
以下因素与无透析肾移植率低于预期有关，比如：
- 供体肾脏短缺
- 缺乏接触移植中心的途径
- 在社会经济地位较低的候选人中，医生转介手术的比例较低
- 医生对现行指南缺乏认识
目的
终末期肾病患者在透析前进行无透析肾移植的好处包括：
- 降低对捐赠肾脏出现排斥的风险
- 提高生存率
- 提高生活质量
- 降低治疗成本
- 避免接受透析及其相关的饮食限制和并发症
无透析肾移植的好处对于患有终末期肾病的儿童和青少年尤为重要。
无透析肾移植的风险包括早期暴露于手术的相关风险，并可能消耗原生肾功能。
风险
Like any surgery, preemptive kidney transplant has risks. Two of the most common risks are:
- Being exposed to the problems of surgery sooner than if you had waited to get a kidney transplant.
- Possibly losing what kidney function you do have.
Though preemptive kidney transplants are often more successful than kidney transplants done after dialysis starts, a kidney transplant is not a cure. You need to take anti-rejection medicines for the rest of your life. These medicines also can have risks and side effects. Your healthcare team goes over all of the risks and side effects of transplant surgery.
如何进行准备
First, you talk with members of your healthcare team. They can help you understand the transplant process and whether it's right for you.
Timing is critical. Talk with your care team about preemptive kidney transplant before your kidneys fail. If you have friends or family members who are willing to donate a kidney, they should get tested right away to see if they are a match. Waiting for a kidney from a deceased donor could mean you wait longer.
Choosing a transplant center
If your healthcare team recommends a preemptive kidney transplant, you will be referred to a transplant center for evaluation. You may be able to select a transplant center on your own or choose one from your insurance company's list of preferred centers.
Some things to consider when choosing a transplant center are:
- The number and type of transplants performed each year.
- Patient survival rates.
- Insurance coverage and costs.
- Whether the transplant center performs living donations, if you have a living donor.
- Any support services available.
可能出现的情况
如果医生建议无透析肾移植，则您将被转诊到移植中心进行评估。您也可以自由选择移植中心或从您的保险公司首选医疗服务提供者列表中选择一家中心。
在移植中心，您的移植团队将进行几项测试，以确定无透析肾移植是否适合您。您的团队将考虑多项因素，包括：
- 肾功能水平
- 整体健康状况
- 任何可能影响移植成功的慢性医疗状况
- 供体肾脏的可用性
- 在您的余生中遵循医疗指示并服用抗排斥药的能力
如果您已获准进行无透析肾移植并且有活体供肾，则医生将安排活体移植手术。如果没有可用的活体供肾，您会被列入已故供体肾脏移植等待清单。
结果
After your kidney transplant, you continue to see your healthcare team for regular checkups. Members of the care team make sure that your kidney is working like it should and that you are taking the right amount of anti-rejection medicine. Let your care team know right away if you are having any signs of rejection, such as:
- Fever.
- Less urine or urinating less often.
- Swelling.
- Weight gain.
- Kidney pain.
It may take several weeks before you can go back to your typical activities. Most people can return to work after 6 to 8 weeks, but each person's recovery is different. Your recovery depends on many personal factors, such as any other medical conditions you have and how well your body responds to the new kidney.