Najarian J S, Chavers B M, McHugh L E, Matas A J
Department of Surgery, University of Minnesota, Minneapolis 55455.
Lancet. 1992 Oct 3;340(8823):807-10. doi: 10.1016/0140-6736(92)92683-7.
The perioperative and long-term risks for living kidney donors are of concern. We have studied donors at the University of Minnesota 20 years or more (mean 23.7) after donation by comparing renal function, blood pressure, and proteinuria in donors with siblings. In 57 donors (mean age 61 [SE 1]), mean serum creatinine is 1.1 (0.01) mg/dl, blood urea nitrogen 17 (0.5) mg/dl, creatinine clearance 82 (2) ml/min, and blood pressure 134 (2)/80 (1) mm Hg. 32% of the donors are taking antihypertensive drugs and 23% have proteinuria. The 65 siblings (mean age 58 [1.3]) do not significantly differ from the donors in any of these variables: 1.1 (0.03) mg/dl, 17 (1.2) mg/dl, 89 (3.3) ml/min, and 130 (3)/80 (1.5) mm Hg, respectively. 44% of the siblings are taking antihypertensives and 22% have proteinuria. To assess perioperative mortality, we surveyed all members of the American Society of Transplant Surgeons about donor mortality at their institutions. We documented 17 perioperative deaths in the USA and Canada after living donation, and estimate mortality to be 0.03%. We conclude that perioperative mortality in the USA and Canada after living-donor nephrectomy is low. In long-term follow-up of our living donors, we found no evidence of progressive renal deterioration or other serious disorders.
活体肾供者围手术期及长期风险备受关注。我们对明尼苏达大学捐赠20年及以上（平均23.7年）的供者进行了研究，通过比较供者与其兄弟姐妹的肾功能、血压和蛋白尿情况。57名供者（平均年龄61岁[标准误1]），平均血清肌酐为1.1（0.01）mg/dl，血尿素氮为17（0.5）mg/dl，肌酐清除率为82（2）ml/min，血压为134（2）/80（1）mmHg。32%的供者正在服用降压药，23%有蛋白尿。65名兄弟姐妹（平均年龄58岁[1.3]）在这些变量上与供者无显著差异：分别为1.1（0.03）mg/dl、17（1.2）mg/dl、89（3.3）ml/min和130（3）/80（1.5）mmHg。44%的兄弟姐妹正在服用降压药，22%有蛋白尿。为评估围手术期死亡率，我们就其机构内供者死亡率对美国移植外科医师协会的所有成员进行了调查。我们记录了美国和加拿大活体捐赠后17例围手术期死亡病例，估计死亡率为0.03%。我们得出结论，美国和加拿大活体供肾肾切除术后围手术期死亡率较低。在对我们的活体供者进行长期随访时，我们未发现肾功能进行性恶化或其他严重疾病的证据。
