Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Transpl Int. 2011 Oct;24(10):973-83. doi: 10.1111/j.1432-2277.2011.01295.x. Epub 2011 Jul 1.
To increase the rate of living kidney donation, the long-term safety of nephrectomy must be demonstrated to potential donors. We analyzed long-term donor outcomes and evaluated the standardization of surgical technique. We evaluated 615 donors who underwent Video-assisted minilaparotomy living donor nephrectomy (VLDN) at Yonsei Severance Hospital between 2003 and 2009. Perioperative data and predictors of outcomes were prospectively analyzed. The mean operative time and mean warm ischemia time were 192.7 and 2.2 min, respectively. Mean estimated blood loss was 195.3 ml. The mean post-transplant serum creatinine levels and Modification of Diet in Renal Disease study equation for estimating glomerular filtration rate were 1.1 mg/dl and 68 ml/min/1.73 m(2) , respectively at 5 years after VLDN. The intra-operative and postoperative complication rate were 3.1% and 6.3%, respectively. Delayed renal function, 5-year graft survival, and complication rates of recipients were 1.1%, 98.4%, and 0.4%, respectively. Predictors of operative time were medical history, vessel anomaly, and surgeon experience (>50 cases). The single predictor of intra-operative complications was vessel anomaly. Standardized VLDN is feasible and safe. Our data on long-term outcomes can assist in demonstrating the long-term safety of donor nephrectomy to potential donors. To compare VLDN to other types of donor nephrectomy, a prospective multicenter study must be performed.
为了提高活体肾脏捐献的比例，必须向潜在的捐献者证明肾切除术的长期安全性。我们分析了长期供体的结果，并评估了手术技术的标准化程度。我们评估了 2003 年至 2009 年在延世大学Severance 医院接受视频辅助小切口活体供肾切除术（VLDN）的 615 名供体。前瞻性分析了围手术期数据和结果的预测因素。手术时间的平均值和平均热缺血时间分别为 192.7 分钟和 2.2 分钟。平均估计失血量为 195.3 毫升。VLDN 后 5 年，平均移植后血清肌酐水平和改良肾脏病饮食研究肾小球滤过率估计方程分别为 1.1mg/dl 和 68ml/min/1.73m(2)。术中及术后并发症发生率分别为 3.1%和 6.3%。受者的延迟肾功能、5 年移植物存活率和并发症发生率分别为 1.1%、98.4%和 0.4%。手术时间的预测因素是病史、血管异常和外科医生经验（>50 例）。术中并发症的唯一预测因素是血管异常。标准化的 VLDN 是可行且安全的。我们关于长期结果的数据可以帮助向潜在的捐献者证明肾切除术的长期安全性。为了将 VLDN 与其他类型的供肾切除术进行比较，必须进行前瞻性多中心研究。
