Weitz Jürgen, Koch Moritz, Mehrabi Arianeb, Schemmer Peter, Zeier Martin, Beimler Jörg, Büchler Markus, Schmidt Jan
Department of Surgery, University of Heidelberg, Heidelberg, Germany.
Clin Transplant. 2006;20 Suppl 17:13-6. doi: 10.1111/j.1399-0012.2006.00595.x.
For patients with end-stage renal disease, kidney transplantation is the optimal therapy. Due to organ shortage, however, most patients have to wait on dialysis for a considerable period of time prior to transplantation. Living-donor kidney transplantation is a valid option to expand the organ pool and to reduce waiting time. The risk-benefit ratio of living-donor kidney transplantation needs to be evaluated critically, as healthy persons voluntarily donate an organ for transplantation. The available data from the literature seem to prove that the donor operation can be performed with a minimal perioperative risk. Regarding the long-term course after kidney donation, the published data suggest that the risk is minimal for well-selected healthy donors who are closely followed postoperatively. The potential donor, however, needs to be completely informed regarding the potential short- and long-term risks of kidney donation prior to the planned procedure. From the recipient point of view, transplantation of a kidney from a living donor is a very good if not the optimal option, as the short- and long-term outcomes seem to be favorable compared with cadaveric kidney transplantation. With donor safety being constantly monitored, it seems to be justified to further pursue living-donor kidney transplantation programs.
对于终末期肾病患者，肾移植是最佳治疗方法。然而，由于器官短缺，大多数患者在移植前不得不依靠透析等待相当长的时间。活体供肾移植是扩大器官库和缩短等待时间的有效选择。由于健康人自愿捐献器官用于移植，因此需要严格评估活体供肾移植的风险效益比。文献中的现有数据似乎证明，供体手术可以在最小的围手术期风险下进行。关于供肾后的长期情况，已发表的数据表明，对于精心挑选且术后密切随访的健康供体，风险极小。然而，在计划手术前，潜在供体需要完全了解供肾潜在的短期和长期风险。从受者的角度来看，接受活体供肾移植即使不是最佳选择，也是非常好的选择，因为与尸体肾移植相比，其短期和长期结果似乎更有利。在持续监测供体安全的情况下，进一步推进活体供肾移植项目似乎是合理的。
