亲属活体供肾者术后早期的安全性评估

Evaluation of the early-stage safety of living-related kidney transplant donors

目的探讨亲属活体供肾者术后早期的安全性。方法供肾切取前对43名活体供肾者进行一般情况和社会状况、重要系统功能、免疫配型以及肾脏功能和解剖学(包括常规检查和特殊的有创性检查)等四个方面评估;肾脏切取术后观察供者的一般情况、肾功能以及是否发生并发症。结果43名供者均符合入选标准,供肾切取前的血肌酐为(58.17±12.35)μmol/L,术后1周时的血肌酐为(87.11±21.77)μmol/L,较术前明显上升(P<0.01),上升幅度接近50%,但除1名供者的血肌酐稍高于正常值上限外,其余供者的血肌酐仍在正常范围。术后仅1例出现切口脂肪液化,更换敷料后3周治愈,无其它并发症。结论只要术前对供者进行全面的评估和严格的筛选,术中操作规范,活体供肾是安全的。

Objective To evaluate the safety of living-related kidney donors in the early stage of operation. Methods Forty-three living-related renal allografts were performed from 2003 to 2005. The potential donor evaluation process included as follows： general condition, socioeconomic aspects, histocompatibility typing, renal function and anatomy, After operation, the results of renal function and the surgical complications of donors were evaluated. Results All the potential donors were identified on the basis of the criteria. Except one case with slight increase of serum creatinine （SCr） exceeding normal range, the others had normal SCr levels which had a significant increase in the first week postoperation （87. 11±21.77μmol/1） vs. that preoperation （58. 17±12. 35μmol/1）. The donors reco- vered perfectly without serious surgical complications, and only one case of wound infection appeared. Conclusions Both rigorous selection and preliminary assessment of potential donors and surgical operation are critical for the success of living-related kidney transplantation.