Mateo Rod, Henderson Randy, Jabbour Nicolas, Gagandeep Singh, Goldsberry Anne, Sher Linda, Qazi Yasir, Selby Robert R, Genyk Yuri
Division of Hepatobiliary/Pancreatic Surgery and Abdominal Organ Transplantation, Department of Surgery, Keck-USC School of Medicine, Los Angeles, CA 90033, USA.
Transpl Int. 2007 Jun;20(6):490-6. doi: 10.1111/j.1432-2277.2007.00464.x. Epub 2007 Feb 20.
Many transplant programs are averse to evaluate potential kidney donors with preferences against accepting human blood products. We examined the donor and graft outcomes between our transfusion-consenting (TC) and transfusion-refusing (TR) live kidney donors to determine whether a functional or survival disadvantage resulted from the disallowance of blood product transfusion during live donor (LD) nephrectomy. From July, 1999 to August, 2005, 82 live donor nephrectomies were performed, eight of who were TR donors (10%). Blood conservation techniques were utilized in TR donors. Demographics, surgical and functional outcomes, admission and discharge hematocrit, and creatinine were compared between TC and TR donors. No donor mortalities occurred. Two TC donors received blood transfusions (2.7%), and each study group experienced a single, <1-year graft loss. Intra-operative blood losses were significantly less in TR donors (298 +/- 412 vs. 121 +/- 91 ml, P < 0.03). No differences were noted between donor demographics, intra-operative events, and graft and patient survival. Successful donor nephrectomy from TR patients has the potential to expand the kidney allograft pool to include the TR donor population. Precautionary blood conservation methods allow the informed and consenting TR individual to donate a kidney with acceptable risk and without compromise to donor or graft outcomes.
许多移植项目不愿对那些不愿意接受人类血液制品的潜在肾脏供体进行评估。我们研究了我们的同意输血（TC）和拒绝输血（TR）的活体肾脏供体之间的供体和移植物结果，以确定在活体供体（LD）肾切除术中不允许输血是否会导致功能或生存劣势。从1999年7月到2005年8月，共进行了82例活体供体肾切除术，其中8例为TR供体（10%）。TR供体采用了血液保护技术。比较了TC和TR供体之间的人口统计学、手术和功能结果、入院和出院时的血细胞比容以及肌酐水平。没有供体死亡发生。两名TC供体接受了输血（2.7%），每个研究组都有一例移植肾丢失，时间均小于1年。TR供体的术中失血量明显较少（298±412 vs. 121±91 ml，P<0.03）。在供体人口统计学、术中事件以及移植肾和患者生存率方面未发现差异。成功地从TR患者中获取供肾有可能扩大肾脏移植库，将TR供体群体纳入其中。预防性血液保护方法使知情并同意的TR个体能够在可接受的风险下捐献肾脏，且不会损害供体或移植肾的结果。
