Troppmann Christoph, Perez Richard V, McBride Maureen
Department of Surgery, University of California, Davis, Sacramento, CA 95817, USA.
Transplantation. 2008 Mar 27;85(6):916-9. doi: 10.1097/TP.0b013e318166ad77.
Prior studies that included both adult and pediatric recipients suggested slower early graft function for laparoscopically (vs. openly) procured live donor kidney grafts (LD-Ktxs). Any potential long-term impact, however, remains unknown. We compared long-term outcomes of 2685 (49%) laparoscopic vs. 2847 (51%) open LD-Ktxs reported to the Organ Procurement and Transplantation Network performed in adult (> or =18 yrs) recipients between November 1999 and December 2000, with follow-up to February 2006. Acute and chronic rejection accounted for 152 laparoscopic (51%) vs. 148 (46%) open graft losses (P=NS). At discharge and at 5 years, graft function was similar for both groups; graft survival at 5 years was 79% (laparoscopic) vs. 80% (open) (P=NS). We conclude that despite prior reports of slower early laparoscopic LD-Ktx function, both laparoscopic and open nephrectomy are equally effective for procurement of kidneys for adult recipients with regard to short- and long-term (>5 years) function and survival. Future studies must investigate whether these findings apply also to pediatric LD-Ktx recipients.
先前纳入成人和儿童受者的研究表明，腹腔镜获取（与开放获取相比）的活体供肾移植（LD-Ktx）早期移植肾功能较慢。然而，任何潜在的长期影响仍不清楚。我们比较了1999年11月至2000年12月期间在成人（≥18岁）受者中进行的、向器官获取与移植网络报告的2685例（49%）腹腔镜LD-Ktx与2847例（51%）开放LD-Ktx的长期结果，随访至2006年2月。急性和慢性排斥反应导致152例（51%）腹腔镜移植肾失功，148例（46%）开放移植肾失功（P=无显著性差异）。出院时和5年时，两组的移植肾功能相似；5年时移植肾存活率为79%（腹腔镜）对80%（开放）（P=无显著性差异）。我们得出结论，尽管先前有报道称腹腔镜LD-Ktx早期功能较慢，但就短期和长期（>5年）功能及存活率而言，腹腔镜和开放肾切除术在为成人受者获取肾脏方面同样有效。未来的研究必须调查这些发现是否也适用于儿童LD-Ktx受者。
