自1982年10月至1996年10月，共有415人次的腎臟移植患者在本院接受換腎後追蹤。其中211人次在本院接受腎臟移植，24人次在其它醫院接受腎臟移植後在本院接受追蹤。在這415人次的腎臟移植患者當中，共有15人接受移植腎切除。而這15例移植腎切除的適應症，12例是因為排斥，1例是因移植腎感染，1例是移植腎動靜脈畸型併發移植腎破裂。另外，1例是因移植腎之腎動脈與腸骨動脈吻合破裂出血而接受移植腎切除。而在12例因排斥而行移植腎切除者當中，8例是因慢性排斥，4例是因急性排斥。而移植腎切除之手術方式有5例是行後腹膜腔腎包囊外全切除，有7例是行後腹膜腔腎包囊內腎實質切除，有3例是經由腹腔內行移植腎切除。手術之併發症是26.7% (4/15)，其中腎包囊外全切除之併發症較輕微，有20% (1/5)，而腎包囊內腎實質切除組之併發症較厲害也較高42.9% (3/7)，其中並有一例病患因手術併發症而死亡。另外有2例病患在住院當中因其它非移植腎切除之併發症而死亡。總和死亡率為20% (3/15)。由於病人本身為慢性腎衰竭及免疫抑制之狀態，使得手術產生較高之併發症及死亡率。因此我們建議，儘量經由腎包囊外行移植腎全切除或是經由腹腔內行移植腎切除較之高併發症之腎包囊內腎實質切除術來得好。

From Oct. 1982 to Oct. 1996, totally 415 cases of kidney transplantation, including 211 cases done in our hospital and 204 in other hospitals, were followed regularly in our hospital, and 15 of them finally received graft nephrectomy. The indications for graft nephrectomy were rejection in 12 patients, graft infection in 1, arterio-venous malformation (AVM) with graft kidney rupture in 1 and arterial anastomosis leakage after kidney transplantation in 1. The causes of rejection were chronic in 8 and acute in 4. The removal was done in extraperitoneal (extracapsular n=5, subcapsular n=7) or transperitoneal approach (n=3). The overall complication rate was 26.7% (4/15). The only complication in extracapsular group was minor and the 3 cases of complication in subcapsular group were more serious. No complication occurred in transperitoneal group. One patient died of surgical complication and two died unrelated to nephrectomy. The overall mortality was 20%. The operative morbidity and mortality were not negligible because of underlying uremia and immunosuppressive status. We suggest to perform graft nephrectomy in extracapsular or transperitoneal approach when it is feasible because the subcapsular approach is difficult to achieve a low complication rate.