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[活体供体的选择]

[Selection of the living donor].

作者信息

Hourmant Maryvonne

机构信息

Service de néphrologie et d'immunologie clinique, CHU de Nantes, 44093 Nantes cedex, France.

出版信息

Nephrol Ther. 2008 Feb;4(1):63-6. doi: 10.1016/j.nephro.2007.07.015. Epub 2007 Dec 31.

Abstract

Although the check-up and criteria of selection of the living donor are still not standardized, recommendations have been issued after a consensus conference in 2004. Besides absolute contraindications related to donor or recipient renal or extrarenal condition, the main selection criteria are the absence of hypertension and cardiovascular disease, GFR >80ml/min, proteinuria<0.30g per day and absence of hematuria of renal origin, presence of overt diabetes, a body mass index >35kg/m(2). Caution is recommended in donors with risk factors of diabetes, a body mass index >30, having a history of renal stones of metabolic origin and tending to recur. With some exceptions, a past history of cancer is not a systematic contraindication to donation, providing the cancer is treatable, in remission and not susceptible to be transferred to the recipient. These criteria still need to be refined.

摘要

尽管活体供体的检查及选择标准仍未标准化,但在2004年的一次共识会议后已发布了相关建议。除了与供体或受体肾脏及肾外状况相关的绝对禁忌证外,主要选择标准包括无高血压和心血管疾病、肾小球滤过率(GFR)>80ml/分钟、蛋白尿<0.30g/天且无肾源性血尿、无明显糖尿病、体重指数>35kg/m²。对于有糖尿病风险因素、体重指数>30、有代谢性肾结石病史且易于复发的供体,建议谨慎考虑。除某些例外情况外,既往有癌症病史并非捐赠的系统性禁忌证,前提是癌症可治疗、处于缓解期且不易转移给受体。这些标准仍需完善。

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