Oh C K, Yoon S N, Lee B M, Kim J H, Kim S J, Kim H, Shin G T
Department of Surgery, Ajou University School of Medicine, 5 Wonchon-Dong, Yeongtong-Gu, Suwon 443-721, Korea.
Transplant Proc. 2006 Sep;38(7):1971-3. doi: 10.1016/j.transproceed.2006.06.022.
The functional capacity of each kidney of a healthy donor may change under the influence of genetic and environmental factors. An assumption that the donor kidneys show equal function is not always true. As part of the pre-nephrectomy evaluation of potential donors, radioisotope renal scintigraphy using technetium-99m diethylenetriaminepentaacetic acid (99mTcDTPA) was routinely included to evaluate renal functional asymmetry of undetermined etiology. The functional ratios of each kidney using 99mTcDTPA as well as serum creatinine (Scr) and creatinine clearance (Ccr) in a 24-hour urine were measured and calculated from a hundred donors. The left kidneys showed greater function (51.67%-53.35% under 95% confidence interval [CI]) and the average left versus right ratio was 52.5 versus 47.5. The average fraction of Ccr of left kidneys was 57.8 mL/min/1.73 m +/- 10.99 compared with right kidneys at 52.6 mL/min/1.73 m +/- 11.63. Seventy-three healthy volunteers donated their left kidneys, and 27, their right kidney. The average fraction of Ccr of the donated kidneys was 55.9 mL/min/1.73 m +/- 11.78 compared with that of the remnant kidneys (54.5 mL/min/1.73 m +/- 11.39). After kidney donation, the Scr of the donors increased from 0.85 mg/dL +/- 0.17 to 1.33 mg/dL +/- 0.27. The average postnephrectomy Ccr was 68.0 mL/min/1.73 m +/- 14.29. Even though the Ccr after kidney donation was higher than that of the remnant kidney estimated before the donation, one must pay attention to possible functional kidney asymmetry to select the nephrectomy site.
健康供体每个肾脏的功能能力可能会在遗传和环境因素的影响下发生变化。认为供体肾脏功能相等的假设并不总是正确的。作为对潜在供体肾切除术术前评估的一部分，常规进行使用锝-99m二乙三胺五乙酸（99mTcDTPA）的放射性核素肾闪烁显像，以评估病因不明的肾功能不对称性。测量并计算了100名供体使用99mTcDTPA时每个肾脏的功能比率以及血清肌酐（Scr）和24小时尿肌酐清除率（Ccr）。左肾显示出更强的功能（在95%置信区间[CI]下为51.67%-53.35%），左肾与右肾的平均比率为52.5比47.5。左肾Ccr的平均分数为57.8 mL/min/1.73 m±10.99，而右肾为52.6 mL/min/1.73 m±11.63。73名健康志愿者捐献了左肾，27名捐献了右肾。捐献肾脏的Ccr平均分数为55.9 mL/min/1.73 m±11.78，而剩余肾脏为54.5 mL/min/1.73 m±11.39。肾切除术后，供体的Scr从0.85 mg/dL±0.17升高至1.33 mg/dL±0.27。肾切除术后Ccr平均为68.0 mL/min/1.73 m±14.29。尽管肾切除术后的Ccr高于捐献前估计的剩余肾脏的Ccr，但在选择肾切除部位时必须注意可能存在的功能性肾不对称。
