目的:分析亲属活体肾移植资料,总结亲属活体肾移植的经验。方法:158例亲属活体肾移植中除7例为夫妻间供肾外其余为血缘亲属供肾。供、受者HLA有5个抗原错配者2例,4个抗原错配5例,3个抗原错配88例,2个抗原错配50例,1个抗原错配12例,无抗原错配1例。158例供者均经开放手术取肾。35例取供者右肾,123例取左肾,术后采用环孢素A(CsA)或普乐可复(FK506)、霉酚酸酯(MMF)及强的松(Pred)免疫抑制治疗。结果:所有158例供者均健康存活,6个月和1年时血肌酐正常。受者健康存活最长者至2008年6月已达10年,1年带肾健康存活率95.5%,5例发生移植肾功能延迟恢复(DGF),其中4例2～5周肾功能恢复正常。死亡5例,其中1例术后发生DGF,透析期间死亡,另4例术后3～5月因肺部感染死亡。1例发生超急性排斥反应,术中切除移植肾脏,行第2次尸体肾移植。5例在移植后1月内发生急性排斥反应,发生率为3.16%,其中4例经甲基强的松龙(MP)冲击治疗后逆转,另1例合并CsA肾中毒,治疗无效,恢复透析治疗。3例1年半至3年半发生慢性排斥,移植肾丧失功能。8例发生肺部感染,4例治愈。结论:活体肾移植由于术前准备充分、组织相容程度高、供肾质量好等优点,使DGF和急性排斥反应等发生率低,人肾存活率高。活体亲属供肾移植同样要重视DGF的预防,排斥反应的防治,免疫抑制剂的合理使用和继发感染等并发症的防治。加强对活体亲属供者的规范选择和全面的健康评估、加强长期随访对保证减少供者伤害、使供者健康存活、正常生活工作非常重要。 OBJECTIVE: To analyze the data of living donor kidney transplantation and to summarize the experience of relative living kidney transplantation. Methods: 158 cases of living relatives kidney transplantation in addition to 7 cases for the couple outside the kidney for the remaining relatives of the kidney. There were 2 mismatches with 5 antigens for donor and recipient HLA, 5 mismatches for 4 antigens, 88 mismatches for 3 antigens, 50 mismatches for 2 antigens, 12 mismatches for 1 antigen and no antigenic errors With 1 case. All 158 donors were treated with open surgery. Thirty-five patients received donor’s right kidney and 123 patients received left kidney. Postoperative CsA or FK506, MMF and Pred immunosuppressive therapy . Results: All 158 donors survived well, with normal serum creatinine at 6 months and 1 year. Recipients of the longest health survival to June 2008 has reached 10 years, 1 year with kidney health survival rate of 95.5%, 5 cases of delayed graft function (DGF), of which 4 cases 2 to 5 weeks of normal renal function returned to normal . 5 died, of which 1 died of DGF after dialysis and 4 died of pulmonary infection from March to May after operation. One case had hyperacute rejection, the kidneys were removed during operation, and the second cadaveric kidney transplantation was performed. In 5 cases, acute rejection occurred within 1 month after transplantation, with a rate of 3.16%. Among them, 4 cases were reversed by methylprednisolone (MP) shock treatment and the other 1 case complicated with CsA nephrotoxicity. The treatment was ineffective and dialysis was resumed treatment. Three cases of chronic rejection of 1 year and a half to 3 years and a half, graft loss of function. 8 cases of lung infection, 4 cases of cure. CONCLUSION: Live renal transplantation has the advantages of low preoperative preparation, high histocompatibility, good donor kidney quality, low incidence of DGF and acute rejection, and high survival rate of human kidney. Living relatives for kidney transplantation should also pay attention to the prevention of DGF, prevention and treatment of rejection, the rational use of immunosuppressive agents and secondary infection and other complications prevention and treatment. To strengthen the normative selection and comprehensive health assessment of living-related donors and to strengthen long-term follow-up is very important for ensuring that donor donations are harmed, donors are healthy and their lives are normal.