Johnson David W, Mudge David W, Kaisar Mohammed O, Campbell Scott B, Hawley Carmel M, Isbel Nicole M, Wall Daryl, Griffin Anthony, Preston John, Nicol David L
Queensland Renal Transplant Service, University of Queensland, Princess Alexandra Hospital, Brisbane, QLD, Australia.
Nephrol Dial Transplant. 2006 Sep;21(9):2583-8. doi: 10.1093/ndt/gfl268. Epub 2006 May 30.
The aim of the present study was to determine whether the deceased donor kidney side (left or right kidney) was predictive of subsequent kidney transplant outcomes.
A retrospective analysis was undertaken of the left-right deceased donor kidney pairs transplanted into recipients with end-stage renal failure in Queensland between 1 April 1994 and 31 March 2004.
A total of 201 left-right deceased donor kidney pairs were transplanted into 402 patients. The baseline characteristics of the recipients in the two groups were comparable, except that the patients receiving right kidneys had lower body mass indices and shorter cold ischaemic times. No differences were seen between the left and right kidney recipient groups with respect to operative duration (3.02 +/- 0.67 vs 3.12 +/- 0.72 h, P = 0.16), warm ischaemic time (0.62 +/- 0.18 vs 0.65 +/- 0.21, P = 0.09), delayed graft function (4 vs 6%, respectively, P = 0.26) or a composite vascular, haemorrhagic, ureteric and infective post-operative complication end-point (22 vs 22%, P = 0.90). Estimated glomerular filtration rates were almost identical at 1 month (52.7 +/- 39.6 vs 51.0 +/- 24.0 ml/min/1.73 m(2), P = 0.34) and remained comparable thereafter. Respective death-censored graft survival rates for left and right kidney recipients were 100 and 100% at 1 year, 99.4 and 96.4% at 3 years and 96.3 and 95.5% at 5 years, respectively (P = 0.67).
Although left and right deceased donor kidneys present different operative challenges, the present results suggest that the probability of early post-operative complications, delayed graft function, impaired early and medium-term renal allograft function or death-censored graft failure is comparable between left and right kidney recipients.
本研究的目的是确定死亡供肾的侧别（左肾或右肾）是否能预测后续肾移植的结果。
对1994年4月1日至2004年3月31日期间在昆士兰移植给终末期肾衰竭受者的左右死亡供肾对进行回顾性分析。
共将201对左右死亡供肾移植给402例患者。两组受者的基线特征具有可比性，但接受右肾的患者体重指数较低且冷缺血时间较短。左肾和右肾受者组在手术时间（3.02±0.67对3.12±0.72小时，P = 0.16）、热缺血时间（0.62±0.18对0.65±0.21，P = 0.09）、移植肾功能延迟恢复（分别为4%对6%，P = 0.26）或血管、出血、输尿管和感染性术后并发症复合终点（22%对22%，P = 0.90）方面未见差异。1个月时估计肾小球滤过率几乎相同（52.7±39.6对51.0±24.0 ml/min/1.73 m²，P = 0.34），此后仍具有可比性。左肾和右肾受者的死亡校正移植存活率在1年时分别为100%和100%，3年时分别为99.4%和96.4%，5年时分别为96.3%和95.5%（P = 0.67）。
尽管左右死亡供肾带来不同的手术挑战，但目前的结果表明，左肾和右肾受者术后早期并发症、移植肾功能延迟恢复、早期和中期肾移植功能受损或死亡校正移植失败的概率相当。
