Hsu Thomas H S, Su L i-Ming, Trock Bruce J, Ratner Lloyd E, Colombani Paul, Kavoussi Louis R
James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD 21224, USA.
Urology. 2003 Feb;61(2):320-2. doi: 10.1016/s0090-4295(02)02122-2.
To evaluate retrospectively our laparoscopic adult donor nephrectomy experience for pediatric transplantation. Since February 1995, 7 adult donors have undergone laparoscopic donor nephrectomy for pediatric renal transplantation (recipients younger than 18 years and weighing less than 30 kg). The outcomes of these donors and pediatric recipients were evaluated. The 7 laparoscopic renal donors had a median operative time of 306 minutes, median allograft warm ischemia time of 275 seconds, median blood loss of 200 mL, median hospital stay of 3 days, and 14.2% overall complication rate. No graft loss or patient mortality occurred. The pediatric recipients of the laparoscopic live-donor allografts had a median creatinine clearance level of 52.1, 52.1, 44, and 41.1 mL/min at 3, 6, 12, and 18 months, respectively. The overall complication rate was 14.2%. The 1 and 2-year graft survival rates were 100%. No mortality occurred in the pediatric recipients. Laparoscopic donor nephrectomy is well tolerated by the adult donors and appears to provide acceptable recipient and allograft outcomes in the pediatric population.
回顾性评估我们在成人活体供肾肾切除术用于小儿肾移植方面的经验。自1995年2月以来,7例成人供者接受了用于小儿肾移植(受者年龄小于18岁且体重小于30kg)的腹腔镜供肾肾切除术。对这些供者和小儿受者的结局进行了评估。7例腹腔镜供肾者的中位手术时间为306分钟,中位移植肾热缺血时间为275秒,中位失血量为200mL,中位住院时间为3天,总体并发症发生率为14.2%。未发生移植物丢失或患者死亡。接受腹腔镜活体供肾移植的小儿受者在术后3、6、12和18个月时的肌酐清除率中位数分别为52.1、52.1、44和41.1mL/min。总体并发症发生率为14.2%。1年和2年移植物存活率均为100%。小儿受者未发生死亡。成人供者对腹腔镜供肾肾切除术耐受性良好,且在小儿人群中似乎能提供可接受的受者和移植物结局。