Wu Yi-Ju, Veale Jeffrey L, Gritsch Hans Albin
Department of General Surgery, Show Chwan Memorial Hospital, Chung Shan Medical University, Taiwan.
Transplantation. 2008 Nov 15;86(9):1196-8. doi: 10.1097/TP.0b013e318187bd37.
Because of the shortage of deceased donor kidneys, some patients are on dialysis for over 10 years before renal transplantation. Many of these patients are anuric. We reviewed the urological complications in renal transplant recipients with anuria on hemodialysis for more than 10 years, compared with preemptive transplant recipients.
The records of 4012 renal transplants from January 1988 to September 2007 were retrospectively reviewed. A total of 2735 deceased donor transplants were performed during this period. We identified a group of patients who were on hemodialysis for over 10 years and made less than 500 mL of urine per day. We compared the rate of urologic complications in this group with patients who were never on dialysis and had normal bladder function based on history and physical examination.
Seventy-two patients met the strict inclusion criteria. There were 41 recipients in the anuric group and 31 recipients in the preemptive group. The surgical complications were not significantly different between the two groups (P=0.503). However, the anuric group required five more hospital admissions for complicated urinary tract infections (P=0.044).
Renal transplant recipients who have been anuric for a prolonged period have higher rates of complicated urinary tract infections, but the long-term risks of urological complications are not significantly different.
由于 deceased 供体肾脏短缺，一些患者在肾移植前接受透析治疗超过 10 年。这些患者中有许多人无尿。我们回顾了长期接受血液透析且无尿的肾移植受者的泌尿系统并发症，并与择期移植受者进行了比较。
回顾性分析了 1988 年 1 月至 2007 年 9 月期间 4012 例肾移植的记录。在此期间共进行了 2735 例 deceased 供体移植。我们确定了一组接受血液透析超过 10 年且每日尿量少于 500 mL 的患者。我们将该组患者的泌尿系统并发症发生率与根据病史和体格检查从未接受透析且膀胱功能正常的患者进行了比较。
72 例患者符合严格的纳入标准。无尿组有 41 例受者，择期组有 31 例受者。两组的手术并发症无显著差异（P = 0.503）。然而，无尿组因复杂性尿路感染需要多住院 5 次（P = 0.044）。
长期无尿的肾移植受者发生复杂性尿路感染的几率更高，但泌尿系统并发症的长期风险无显著差异。
