巨大血管平滑肌脂肪瘤切除术后成功的活体供肾肾移植。
A successful live donor kidney transplantation after large angiomyolipoma excision.
作者信息
Abboudi H, Chandak P, Kessaris N, Fronek J
机构信息
Renal Transplant Unit, St. George's Hospital, London SW17 0QT, United Kingdom.
出版信息
Int J Surg Case Rep. 2012;3(12):594-6. doi: 10.1016/j.ijscr.2012.07.016. Epub 2012 Aug 21.
INTRODUCTION
Angiomyolipoma is the most common benign neoplasm of the kidney. Successful transplantation of an AML affected kidney has been reported. However it is still often seen as a contraindication to transplantation.
PRESENTATION OF CASE
A 47-year-old female underwent assessment for a direct specified kidney donation to her husband who had end stage renal failure, due to adult polycystic kidney disease. Routine pre-operative CT angiography demonstrated a large 6cm×4cm AML arising from the upper pole of the right kidney. Right-side hand assisted retro-peritoneoscopic live donor nephrectomy with bench tumour excision was subsequently performed. Recipient implantation was unremarkable with no haemorrhage.
DISCUSSION
Histology confirmed a 7cm AML. At 36 months follow up, the recipient's serum creatinine was 158μmol/l and eGFR 40ml/min without the need for dialysis at any stage.
CONCLUSION
AML should not be a contraindication for specified live kidney donation, despite a size of 7cm.
引言
血管平滑肌脂肪瘤是最常见的肾脏良性肿瘤。已有报道成功移植患有血管平滑肌脂肪瘤的肾脏。然而，它仍常被视为移植的禁忌证。
病例介绍
一名47岁女性接受评估，准备直接将一个特定的肾脏捐献给因成人多囊肾病而处于终末期肾衰竭的丈夫。术前常规CT血管造影显示右肾上极有一个6厘米×4厘米的大血管平滑肌脂肪瘤。随后进行了右侧手辅助后腹腔镜活体供肾切除术及台上肿瘤切除术。受者植入过程顺利，无出血情况。
讨论
组织学检查证实为一个7厘米的血管平滑肌脂肪瘤。在36个月的随访中，受者的血清肌酐为158μmol/l，估算肾小球滤过率为40ml/分钟，在任何阶段都无需透析。
结论
尽管血管平滑肌脂肪瘤大小为7厘米，但不应将其作为特定活体肾捐献的禁忌证。
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