Husted T L, Hanaway M J, Thomas M J, Woodle E S, Buell J F
University of Cincinnati, Cincinnati, Ohio 45249, USA.
Transplant Proc. 2005 Mar;37(2):631-2. doi: 10.1016/j.transproceed.2004.12.126.
Left laparoscopic donor nephrectomy (LDN) is preferred over right LDN due to technical ease. The purpose of this study was to compare results between right and left LDN and thereby determine whether substantial experience with right LDN can provide results equivalent to left LDN.
All LDN from 2000 to 2004 were reviewed, and right LDN data compared to left LDN data. Statistical analyses included chi-square and Student t tests.
Two hundred thirteen left LDN (84%) were compared to 40 right LDN (16%). Donor age, gender, race, and body mass index, and multiple arteries were similar in right and left LDN groups. Operative and cold ischemia times were similar, but warm ischemia was longer for right LDN (3:55 +/- 1:22 minutes) than left LDN (3.18 +/- 1:06 minutes; P = .004). Despite this, renal allograft function was similar on postoperative day 7 (creatinine 1.77 +/- 1.21 for right LDN, 1.7 +/- 1.5 for left LDN) and at 1 year (right LDN 1.5 +/- 0.4, left LDN 1.23 +/- 0.28). Graft survival rate in the right LDN at 1 year was 97.5%.
This large experience with right LDN indicates that results comparable to left LDN can be obtained. This observation increases the options for LDN in patients with multiple left renal arteries, or with right renal cysts, or with right kidneys that are smaller in size compared to the contralateral left kidney.
由于技术操作相对简便，腹腔镜下左肾供体切除术（LDN）比右肾LDN更受青睐。本研究的目的是比较右肾和左肾LDN的结果，从而确定丰富的右肾LDN经验是否能产生与左肾LDN相当的结果。
回顾了2000年至2004年期间所有的LDN病例，并将右肾LDN数据与左肾LDN数据进行比较。统计分析包括卡方检验和学生t检验。
将213例左肾LDN（84%）与40例右肾LDN（16%）进行了比较。右肾和左肾LDN组的供体年龄、性别、种族、体重指数以及多支动脉情况相似。手术时间和冷缺血时间相近，但右肾LDN的热缺血时间（3:55±1:22分钟）长于左肾LDN（3.18±1:06分钟；P = 0.004）。尽管如此，术后第7天肾移植功能相似（右肾LDN肌酐为1.77±1.21，左肾LDN为1.7±1.5），1年后也相似（右肾LDN为1.5±0.4，左肾LDN为1.23±0.28）。右肾LDN 1年时的移植物存活率为97.5%。
大量的右肾LDN经验表明，可以获得与左肾LDN相当的结果。这一观察结果增加了在有多支左肾动脉、右肾囊肿或右肾比左肾对侧更小的患者中进行LDN的选择。
