Salvatierra O, Wolfson M, Cochrum K, Amend W, Belzer F O
J Urol. 1976 Jan;115(1):5-7. doi: 10.1016/s0022-5347(17)59048-5.
The results have been reviewed of 35 renal transplants performed on 31 patients with end stage polycystic renal disease. Patient survival is 81 per cent and 71 per cent of the patients have functioning grafts at an average followup of 3.1 years. The need for pre-transplant nephrectomy was evaluated early in the series and since then the operation has been practiced selectively. Twenty-two patients have received transplants with both polycystic kidneys in situ, while 2 patients have undergone transplantation after unilateral nephrectomy. In the absence of a history of renal infection or significant hematuria it has proved safe and desirable to leave the polycystic kidneys in situ. During the post-transplant period in such cases there has been no difficulty attributed to the in situ polycystic kidneys after more than 450 patient months of immunosuppressive therapy. The size of the polycystic kidneys has not been an indication of nephrectomy in our series and no significant technical difficulties have been encountered with large polycystic kidneys remaining in situ. Hypertension associated with end stage polycystic kidney disease has been controlled easily and has not proved an indication for pre-transplant nephrectomy.
对31例终末期多囊肾病患者实施的35例肾移植结果进行了回顾。患者生存率为81%，平均随访3.1年时，71%的患者移植肾有功能。在该系列研究早期对移植前肾切除术的必要性进行了评估，此后该手术一直是选择性实施。22例患者移植时多囊肾原位保留，2例患者在单侧肾切除术后接受了移植。在没有肾感染或明显血尿病史的情况下，已证明将多囊肾原位保留是安全且可取的。在这些病例的移植后阶段，经过超过450个患者月的免疫抑制治疗后，未发现因原位多囊肾导致的困难。在我们的系列研究中，多囊肾的大小并非肾切除术的指征，保留原位的大的多囊肾未遇到明显的技术困难。与终末期多囊肾病相关的高血压已很容易得到控制，且未证明是移植前肾切除术的指征。
