Palestini M, Randone B, Bianchi G, Ponzio F, Carmellini M, Citterio F, Bretto P, Boggi U, Castagneto M, Cavallaro A
Dottorato di Ricerca Chirurgia nel Paziente Dializzato I Istituto di Clinica Chirurgica, Università degli Studi di Roma La Sapienza, Roma.
Minerva Chir. 2000 Oct;55(10):709-12.
Living related kidney transplantation is considered a gold standard of renal transplantation in order to overcome end-stage renal disease within the same family members. Living donation, albeit decreasing cadaveric donor shortage, exposes donors to the risk of surgical complications.
In order to assess the postoperative complication rate in donors and recipients, we reviewed retrospectively 90 consecutive living related kidney transplants in a multicentric study. All nephrectomies were performed extraperitoneally through a left flank incision.
Major perioperative complications (first 3 weeks after surgery) occurred in 12 subjects: these included bleeding (2.2%), symptomatic pneumothorax (1.1%), iliac thrombophlebitis (3.3%), iliac artery dissection (1.1%), laparotomic dehiscence (2.2%), perirenal hematoma (1.1%), renal artery stenosis (1.1%), urinary fistula (1.1%). Minor perioperative complications took place in 8 cases. One recipient died. Donor postoperative major complications occurred in 2 subjects.
On the basis of these results we conclude that living related kidney transplantation is an important treatment of end stage renal disease, due to the associated low major complication rate and the high feasibility of this methodology.
为了在家庭成员中克服终末期肾病,亲属活体肾移植被视为肾移植的金标准。活体捐赠尽管减少了尸体供体短缺的问题,但使供体面临手术并发症的风险。
为了评估供体和受体的术后并发症发生率,我们在一项多中心研究中回顾性分析了连续90例亲属活体肾移植病例。所有肾切除术均通过左下腹切口经腹膜外进行。
12名受试者发生了主要围手术期并发症(术后前3周):包括出血(2.2%)、症状性气胸(1.1%)、髂静脉血栓形成(3.3%)、髂动脉夹层(1.1%)、剖腹手术切口裂开(2.2%)、肾周血肿(1.1%)、肾动脉狭窄(1.1%)、尿瘘(1.1%)。8例发生了轻微围手术期并发症。1名受体死亡。2名供体发生了术后主要并发症。
基于这些结果,我们得出结论,亲属活体肾移植是终末期肾病的一种重要治疗方法,因为其相关的主要并发症发生率低且该方法的可行性高。