AP-HM, Hôpital de la Conception, Centre de Néphrologie et Transplantation Rénale, Marseille, France.
Am J Transplant. 2013 Feb;13(2):399-405. doi: 10.1111/j.1600-6143.2012.04312.x. Epub 2012 Nov 21.
Anatomical differences between right and left kidneys could influence transplant outcome. We compared graft function and survival for left and right kidney recipients transplanted from the same deceased organ donor. Adult recipients of 4900 single kidneys procured from 2450 heart beating deceased donors in Australia and New Zealand from 1995 to 2009 were included in a paired analysis. Right kidneys were associated with more delayed graft function (DGF) (25 vs. 21% for left kidneys, p < 0.001) and, if not affected by DGF, a slower fall in serum creatinine. One-year graft survival was lower for right kidneys (89.1 vs. 91.1% for left kidneys, p = 0.001), primarily attributed to surgical complications (66 versus 35 failures for left kidneys). Beyond the first posttransplant year, kidney side was not associated with eGFR, graft or patient survival. Receipt of a right kidney is a risk factor for inferior outcomes in the first year after transplantation. A higher incidence of surgical complications suggests the shorter right renal vein may be contributory. The higher susceptibility of right kidneys to injury should be considered in organ allocation.
左右肾脏的解剖差异可能会影响移植的结果。我们比较了从同一已故器官供体中移植的左肾和右肾受者的移植物功能和存活率。纳入了澳大利亚和新西兰在 1995 年至 2009 年期间从 2450 位有心跳的已故供体中获取的 4900 个单肾移植患者的配对分析。与左肾（25% vs. 21%，p < 0.001）相比，右肾更容易发生延迟性移植物功能障碍（DGF），并且如果不受 DGF 影响，则血清肌酐下降速度较慢。右肾的 1 年移植物存活率较低（89.1% vs. 91.1%，p = 0.001），主要归因于手术并发症（66 例与左肾的 35 例失败）。在移植后第一年之后，肾脏侧与 eGFR、移植物或患者存活率无关。接受右肾是移植后第一年不良结果的危险因素。较高的手术并发症发生率表明较短的右肾静脉可能是一个促成因素。在器官分配时，应考虑右肾更容易受到损伤的可能性。
