Minnee Robert C, Bemelman Willem A, Polle Sebastiaan W, van Koperen Paul J, Ter Meulen Sylvia, Donselaar-van der Pant Karlijn A, Bemelman Frederike J, Idu Mirza M
Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Transplantation. 2008 Jul 27;86(2):251-6. doi: 10.1097/TP.0b013e31817789dd.
Older living kidney donors remain controversial because of their physiological decline in glomerular filtration rate and their increased susceptibility of surgical complications. Little is known about the quality of life (QOL) of this elderly group. The purpose of this study is to examine surgical outcome and the QOL in older living donors.
All 105 consecutive living donors who underwent a laparoscopic donor nephrectomy between June 2002 and February 2006 were prospectively included in the study. Intra- and postoperative complications were measured. Quality of life was recorded preoperatively and at several endpoints postoperatively. Older donors were defined as 55 years and older.
There were no significant differences in intra- and postoperative complication rates and 1-year graft survival rate between both groups. Elderly donors (n=34) had both a significant lower postoperative pain at rest at day 1 compared with the younger group (P=0.019) and a lower total pain score in the analysis for the whole follow-up period (P=0.002). Although small solitary significant differences in Short Form-36 Health Survey, Multidimensional Fatigue Inventory-20 and visual analogue scale measuring pain, between both groups were detected, in general QOL of older donors was not different than of younger donors.
Although small solitary significant differences exist with respect to pain, social functioning and mental health older donors, in general, have similar surgical outcome and quality of life when compared with younger donors. There is no need to exclude older donors in screening programs for transplantation.
由于老年活体肾供者肾小球滤过率的生理下降以及手术并发症易感性增加,他们一直存在争议。对于这一年龄较大群体的生活质量知之甚少。本研究的目的是探讨老年活体供者的手术结局和生活质量。
2002年6月至2006年2月期间连续接受腹腔镜供肾切除术的105例活体供者均前瞻性纳入本研究。记录术中及术后并发症。术前及术后几个时间点记录生活质量。年龄较大的供者定义为55岁及以上。
两组术中及术后并发症发生率和1年移植肾存活率无显著差异。与年轻组相比,老年供者(n = 34)在术后第1天静息时的疼痛明显较轻(P = 0.019),且在整个随访期分析中总疼痛评分较低(P = 0.002)。虽然在简短健康调查问卷36项、多维疲劳量表20项以及测量疼痛的视觉模拟量表中两组之间检测到了一些小的显著差异,但总体而言,老年供者的生活质量与年轻供者并无不同。
尽管在疼痛、社会功能和心理健康方面老年供者存在一些小的显著差异,但总体而言,与年轻供者相比,他们具有相似的手术结局和生活质量。在移植筛查项目中无需排除老年供者。