活体肾移植中单发结石供肾的处理与疗效

Treatment and effect of donor kidney with single calculus in living renal transplantation

目的探讨活体肾移植中有单发结石的供肾的处理方法及疗效。方法总结3例术前发现单侧肾结石的活体肾移植供肾的处理经验。切取该侧肾脏作为供肾,并在体外行输尿管镜完整取石,之后按常规术式行肾移植术。结果 3例受体术后均未出现移植物功能延迟恢复、急性排斥反应等早期并发症。3对供、受体分别随访34、45、62个月,行移植肾泌尿系统的彩色多普勒超声检查,供体保存肾及受体移植肾均未见新发结石及尿路梗阻表现。所有供、受体肾功能良好。3例供体随访至今,未发现尿常规异常。其中1例受体术后发生Ig A肾病,考虑为肾病复发,与结石无关。结论对于活体肾移植术中的单发结石,采用供肾切取后体外输尿管镜取石是处理供肾结石的有效方法。

Objective To explore treatment methods of donor kidney with single calculus in living renal transplantation and their effect. Methods The treatment experience of donor kidneys with unilateral renal calculus in living renal transplantation of 3 cases was summarized,which were diagnosed before operation. The kidney with renal calculus was excised as the donor kidney; ureteroscopic lithotomy was conducted in vitro,and then renal transplantation was performed by routine operation. Results There was no early complication such as delayed graft function and acute rejection in 3 recipients after operation. Three pairs of donors and recipients were followed up for 34,45 and 62 months respectively. The color Doppler ultrasound examination of urinary system after renal transplantation showed that,new renal calculus and urinary tract obstruction did not occur in donor＇s preserved kidneys and recipient＇s transplant kidneys. Renal function of all donors and recipients was good. Three donors were followed up until now,and no abnormal urine routine was discovered. One recipient developed Ig A nephropathy,which was considered to be recurrent nephropathy and had nothing to do with renal calculus. Conclusions The donor kidney with single calculus in living renal transplantation can be treated effectively by ureteroscopic lithotomy in vitro after donor kidneys are excised.