Bonfante Luciana, Gemelli A, D'Angelo A
Clinica Nefrologica, Dipartimento di Scienze Mediche e Chirurgiche, Università degli Studi, Padova.
G Ital Nefrol. 2009 Jul-Aug;26(4):460-7.
Kidney transplant from a living donor is known to be the best renal replacement therapy. While not as common as in northern Europe and the USA, living donor transplants are on the rise in Italy. Although there is a large body of evidence in the literature about the safety of the surgical procedure, the risk of long-term complications for the donor has not been clearly defined because of the lack of studies with adequate follow-up and a sufficient number of subjects involved. The main questions concern the development of chronic kidney disease in the donor, expressed as a GFR decline or the presence of microalbuminuria. The physiopathological basis of GFR decline and proteinuria development may differ from the model of nephropathy in patients with two kidneys, and this could involve prognostic differences too, particularly with regard to the cardiovascular risk. Detailed and prolonged follow-up programs are needed to monitor and, if necessary, treat long-term complications in kidney donors.
活体供肾移植被认为是最佳的肾脏替代疗法。虽然不像在北欧和美国那样普遍，但意大利的活体供肾移植数量正在上升。尽管文献中有大量关于该手术安全性的证据，但由于缺乏足够随访时间和足够数量受试者的研究，供体长期并发症的风险尚未明确界定。主要问题涉及供体慢性肾病的发展，表现为肾小球滤过率（GFR）下降或微量白蛋白尿的出现。GFR下降和蛋白尿发展的生理病理基础可能与双肾患者的肾病模型不同，这也可能涉及预后差异，尤其是在心血管风险方面。需要详细且长期的随访计划来监测并在必要时治疗肾供体的长期并发症。
