Percegona L S, Bignelli A T, Adamy A, Machado C, Pilz F, Meyer F, Hokazono S R, Riella M C
Transplant Unit Hospital Santa Casa de Misericórdia de Curitiba, Curitiba, Paraná, Brazil.
Transplant Proc. 2008 Apr;40(3):685-6. doi: 10.1016/j.transproceed.2008.03.006.
Laparoscopic donor nephrectomy (LN) offers less postoperative pain and early recovery in living kidney donors, but graft kidney function in the recipients can be delayed due to prolonged warm ischemic time (WIT) and adverse effects of pneumoperitoneum. We compared the early function of the grafted kidney and the complications in kidney recipients after LN versus open nephrectomy (ON). We analyzed 109 kidney recipients from living donors, including 60 LN and 49 ON, comparing immediate diuresis after surgery, glomerular filtration rate (GFR) by MDRD formula (modification of diet in renal disease) at day 5, and complications. The recipient age among the LN group was 20 to 73 years with 51% men among whom 95% of patients had immediate diuresis with GFR at day 5 varying from 4.85 to 99.45 mL/min/1.73 m(2) by MDRD Surgical complications were renal artery stenosis (5%) and urinary leakage (5%). The recipient among age ON cases varied from 18 to 63 years with 63% men and immediate diuresis observed in 87% and GFR at day 5 varied from 4.75 to 101.1 mL/min/1.73 m(2) by MDRD. Renal artery stenosis was observed in 8.16%. The WIT was longer (P < .05) among the LN (1.4 to 11 minutes) compared with the ON group (1 to 4 minutes). GFR at day 5 showed no difference between the two groups. In conclusion, WIT was higher among LN compared with ON but did not seem to influence early function of the grafted kidney.
腹腔镜供肾切除术（LN）可减少活体肾供者术后疼痛并使其更早康复，但受者的移植肾功能可能因热缺血时间（WIT）延长和气腹的不良影响而延迟。我们比较了LN与开放肾切除术（ON）后移植肾的早期功能及肾受者的并发症。我们分析了109例活体供肾的肾受者，其中60例行LN，49例行ON，比较了术后即刻利尿情况、术后第5天根据肾病饮食改良公式（MDRD）计算的肾小球滤过率（GFR）以及并发症。LN组受者年龄为20至73岁，男性占51%，其中95%的患者术后即刻利尿，术后第5天MDRD计算的GFR为4.85至99.45 mL/min/1.73 m²。手术并发症为肾动脉狭窄（5%）和尿漏（5%）。ON组受者年龄为18至63岁，男性占63%，87%的患者术后即刻利尿，术后第5天MDRD计算的GFR为4.75至101.1 mL/min/1.73 m²。肾动脉狭窄发生率为8.16%。与ON组（1至4分钟）相比，LN组的WIT更长（P < 0.05）（1.4至11分钟）。两组术后第5天的GFR无差异。总之，与ON相比，LN的WIT更高，但似乎并未影响移植肾的早期功能。
