Abdu A, Morolo N, Meyers A, Wadee S, Britz R, Naicker S
Department of Internal Medicine, Division of Nephrology, Faculty of Health Sciences, Charlotte Maxeke Johannesburg Academic Hospital, University of Witwatersrand, South Africa.
Ann Afr Med. 2011 Apr-Jun;10(2):127-31. doi: 10.4103/1596-3519.82077.
Kidney transplantation is the treatment of choice for end-stage renal disease (ESRD). The number of patients on the waiting list is increasing due to an imbalance between organ supply and demand. This has led to an increase in the number of living donor transplants in most parts of the world. The benefits to the recipients must, however, be weighed against the risks to the donors. Long-term follow-up of the donors is therefore imperative to ascertain the risks of living kidney donation.
We reviewed the records of 571 potential living kidney donors (PLDs) in Johannesburg hospital over a 16-year period between 1990 and 2005.
There were 1030 kidney transplants during this period, with 800 cadaveric and 230 actual living donor (ALD) transplants. There were 571 PLDs; however, 341 (59.7%) withdrew or were withdrawn because of medical and non-medical reasons. Among the 230 ALDs, the mean age of the donors was 35.2 ± 8.3 years; 55% were females; 24% were Blacks. Eighty-five percent were related to the recipients while 15% were unrelated. Mean duration of follow-up was 8.6 ± 6.4 years. The pattern of post-donation follow-up was excellent in 29.7%, adequate in 34% and unacceptable/poor in 36.3%, based on the number of clinic visits post-donation. Hypertension was noted in 24% of the donors during long-term follow-up. Three of the donors also developed significant microalbuminuria.
There is a need to encourage living kidney donation, especially amongst the Black populations, and to emphasize the value and significance of post-donation follow-up visits to all potential donors.
肾移植是终末期肾病（ESRD）的首选治疗方法。由于器官供需失衡，等待名单上的患者数量不断增加。这导致世界上大多数地区活体供体移植数量增加。然而，必须将对受者的益处与对供体的风险进行权衡。因此，对供体进行长期随访以确定活体肾捐赠的风险至关重要。
我们回顾了1990年至2005年期间约翰内斯堡医院571名潜在活体肾供体（PLD）的记录。
在此期间共进行了1030例肾移植，其中800例为尸体供肾移植，230例为实际活体供体（ALD）移植。有571名PLD；然而，341名（59.7%）因医学和非医学原因退出或被退出。在230名ALD中，供体的平均年龄为35.2±8.3岁；55%为女性；24%为黑人。85%与受者有亲属关系，15%无亲属关系。平均随访时间为8.6±6.4年。根据捐赠后门诊就诊次数，捐赠后随访模式优秀的占29.7%， adequate的占34%，不可接受/差的占36.3%。长期随访期间，24%的供体出现高血压。三名供体还出现了明显的微量白蛋白尿。
有必要鼓励活体肾捐赠，尤其是在黑人人群中，并向所有潜在供体强调捐赠后随访的价值和意义。
