Thiel Karolin, Thiel Christian, Schenk Martin, Ladurner Ruth, Nadalin Silvio, Heyne Nils, Königsrainer Alfred, Steurer Wolfgang
Universitätsklinik für Allgemeine, Viszeral- und Transplantationschirurgie, Tübingen, Germany.
Wien Klin Wochenschr. 2012 Jan;124(1-2):39-44. doi: 10.1007/s00508-011-0094-9. Epub 2011 Nov 30.
Living donor kidney transplantation is a well-established method to reduce time on the waiting list. Although the laparoscopic donor nephrectomy has already been established worldwide, more than 80% of the living donor nephrectomies are performed as a traditional open donor nephrectomy in Germany. The aim of our study was to analyze perioperative data and long-term outcome of donors and recipients following open donor nephrectomy.
From February 2004 to July 2008, a total of 51 open donor nephrectomies were performed in Tuebingen University Hospital. Forty-five data of corresponding transplant donors and recipients were analyzed. The Kocak classification which provides a format to compare postoperative complications after living donor nephrectomy was used.
Five-year graft survival was 100%. No intraoperative complications occurred. Postoperatively Grad I complications were observed in 10 donors (22.2%). In the long term no major complications occurred. Two donors (4.4%) had newly diagnosed hypertension and required antihypertensive medication. None of the donors developed proteinuria. Right-sided transabdominal donor nephrectomy was associated with a shorter mean hospital stay compared to left-sided lumbar nephrectomy. (7.8 ± 2.4 vs. 9.2 ± 1.8 days, p < 0.05).
Open donor nephrectomy is a safe procedure with an excellent graft survival. Complication rates in our center are comparable to recent results in laparoscopic living donor nephrectomy. Therefore, the open donor nephrectomy remains important.
活体供肾移植是一种成熟的减少等待时间的方法。尽管腹腔镜供肾切除术已在全球范围内确立，但在德国，超过80%的活体供肾切除术是传统的开放性供肾切除术。我们研究的目的是分析开放性供肾切除术后供体和受体的围手术期数据及长期结局。
2004年2月至2008年7月，图宾根大学医院共进行了51例开放性供肾切除术。分析了45例相应移植供体和受体的数据。采用Kocak分类法，该分类法提供了一种比较活体供肾切除术后并发症的形式。
5年移植肾存活率为100%。未发生术中并发症。术后10例供体（22.2%）出现I级并发症。长期来看，未发生重大并发症。2例供体（4.4%）新诊断为高血压，需要服用降压药。所有供体均未出现蛋白尿。与左侧经腰入路供肾切除术相比，右侧经腹供肾切除术的平均住院时间较短。（7.8±2.4天对9.2±1.8天，p<0.05）。
开放性供肾切除术是一种安全的手术，移植肾存活率高。我们中心的并发症发生率与近期腹腔镜活体供肾切除术的结果相当。因此，开放性供肾切除术仍然很重要。
