Kato Taigo, Yazawa Koji, Ichimaru Naotsugu, Saito Jun, Tsutahar Koichi, Kakuta Yoichi, Abe Toyofumi, Nakai Yasutomo, Nonomura Norio, Takahara Shiro, Okuyama Akihiko
Department of Specific Organ Regulation (Urology), Osaka University Graduate School of Medicine.
Nihon Hinyokika Gakkai Zasshi. 2010 Sep;101(6):730-3. doi: 10.5980/jpnjurol.101.730.
28-year-old female received dialysis treatment due to chronic renal failure caused by polycystic kidney disease. Later, she underwent a laparoscopic splenectomy and ABO incompatible living kidney transplantation successfully following bilateral renal contraction therapy with renal transcatheter arterial embolization (renal TAE). A unilateral or bilateral native nephrectomy of a massively enlarged kidney performed at the time of renal transplantation is a common treatment in polycystic kidney patients scheduled for transplantation. On the other hand, when treated with renal TAE, such patients can avoid a laparotomy, which provides several advantages when undergoing peritoneal dialysis in the future or a laparoscopic splenectomy prior to ABO incompatible kidney transplantation. Furthermore, we consider that bilateral renal TAE is necessary for polycystic kidney patients prior to renal transplantation for a variety of reasons, including problems associated with contrast nephropathy if renal TAE for left kidney is remained after renal transplantation.
一名28岁女性因多囊肾病导致慢性肾衰竭而接受透析治疗。后来,在经肾动脉导管栓塞术(肾TAE)进行双侧肾脏缩小治疗后,她成功接受了腹腔镜脾切除术和ABO血型不相容的活体肾移植。在肾移植时对严重肿大的肾脏进行单侧或双侧自体肾切除术是计划进行移植的多囊肾患者的常见治疗方法。另一方面,在接受肾TAE治疗时,此类患者可以避免剖腹手术,这对于未来进行腹膜透析或在ABO血型不相容肾移植之前进行腹腔镜脾切除术具有诸多优势。此外,我们认为,由于多种原因,包括肾移植后如果左肾仍需进行肾TAE会出现造影剂肾病相关问题,多囊肾患者在肾移植前进行双侧肾TAE是必要的。