Rowinski W, Chmura A, Włodarczyk Z, Ostrowski M, Rutkowski B, Domagała P, Dziewanowski K, Matych J, Durlik M, Grenda R
Department of Medical Sciences, University of Warmia, Olsztyn, Poland.
Transplant Proc. 2009 Jan-Feb;41(1):79-81. doi: 10.1016/j.transproceed.2008.08.140.
The first kidney transplantation was performed in Poland in 1966. Since that time approximately 11,000 patients have undergone the procedure, but most of them have received the kidney from deceased donors; only 342 procedures utilized living donors (LD; 2.7%). The aim of this study was to review the results of a LD follow-up in Poland.
A questionnaire was sent to 11 centers that had performed 197 LD kidney transplantations during the last 10 years. The donors, who were all genetically or emotionally related, were 23 to 61 years old. No donor showed an abnormality regarding cardiovascular function or metabolic abnormalities.
The 6 centers that responded reported data on 118 donors. In 2 centers no donor follow-up was available. Eleven of 118 donors did not attend the control visits. Follow-up of the remaining donors ranged from 2 to 8 years. Four donors died at 4 to 5 years after nephrectomy due to cerebral hemorrhage, brain tumor, stomach cancer, or car accident. The overall mean serum creatinine had increased from 0.8 to 1.25 mg/dL, but 2 patients displayed a value >2 mg/dL. The calculated creatinine clearance (MDRD formula) had decreased from 95 to 65 mL/min (P < .05). In 3 donors proteinuria (>0.6 g/24 h) was observed at 3 to 5 years after donation. Of 3 patients who experienced mild hypertension, 2 required treatment. The remaining donors showed normal blood pressures.
Since 2007, when the Living Donor Registry was introduced by law, transplant centers have been obliged to report data on each LD procedure together with follow-up data. All donors are life-insured (by Alianz SA) for 3 months from the time of transplantation. Stepwise interventional reno- and cardioprotection programs have been introduced after nephrectomy for LD, especially those with metabolic abnormalities at the time of donation.
1966年在波兰实施了首例肾移植手术。自那时起，约11000名患者接受了该手术，但他们中的大多数接受的是已故供者的肾脏；仅有342例手术使用了活体供者（LD；占2.7%）。本研究的目的是回顾波兰活体供者随访的结果。
向11个中心发送了调查问卷，这些中心在过去10年中进行了197例活体供者肾移植手术。供者均为有基因或情感关系的亲属，年龄在23至61岁之间。没有供者表现出心血管功能异常或代谢异常。
6个做出回应的中心报告了118名供者的数据。2个中心没有供者随访数据。118名供者中有11名未参加对照访视。其余供者的随访时间为2至8年。4名供者在肾切除术后4至5年因脑出血、脑肿瘤、胃癌或车祸死亡。血清肌酐总体均值从0.8mg/dL升至1.25mg/dL，但有2例患者的值>2mg/dL。计算得出的肌酐清除率（MDRD公式）从95mL/min降至65mL/min（P<.05）。3名供者在捐献后3至5年出现蛋白尿（>0.6g/24h）。3例出现轻度高血压的患者中，2例需要治疗。其余供者血压正常。
自2007年依法设立活体供者登记处以来，移植中心有义务报告每例活体供者手术的数据及随访数据。所有供者自移植时起由安联集团（Alianz SA）承保3个月。肾切除术后已针对活体供者，尤其是那些在捐献时存在代谢异常的供者，引入了逐步的介入性肾脏和心脏保护方案。
