Crotty Charlotte, Tabbakh Yasmin, Hosgood Sarah A, Nicholson Michael L
Transplant Group, Department of Infection, Immunity and Inflammation, Leicester General Hospital, University of Leicester, Leicester LE5 4PW, UK.
J Transplant. 2013;2013:138926. doi: 10.1155/2013/138926. Epub 2013 Dec 16.
Introduction. Systemic heparinisation is advocated during laparoscopic live donor nephrectomy (LDN) as a preventative measure against renal vascular thrombosis during the warm ischaemic interval. This study compares the outcome with and without the administration of systemic heparinisation. Methods. A retrospective analysis was performed on 186 consecutive LDN patients between April 2008 and November 2012. Systemic heparin (2000-3000 IU) was administered intravenously to donors (hep n = 109). From January 2010, heparin was not used systemically in this group of LDN (no hep n = 77). Outcome measures included donor and recipient complications, initial graft function, and 12 month graft survival. Results. The demographics of both heparinised and non-heparinised donors were similar. The warm ischaemic time (WIT) was comparable in both groups (WIT; hep 5 ± 3 versus no hep 5 ± 3 minutes; P = 1.000). There was no difference in complication rates, no episodes of graft thrombosis, and no incidences of primary nonfunction in either group. Delayed graft function occurred in 4/109 and 1/77 (3.6% versus 1.2%; P = 0.405) and there was no significant difference in graft survival (P = 0.650). Conclusion. Omitting systemic heparinisation during laparoscopic donor nephrectomy is a feasible and safe approach that does not compromise donor or recipient outcome.
引言。在腹腔镜活体供肾肾切除术（LDN）期间提倡进行全身肝素化，作为在热缺血期预防肾血管血栓形成的一项措施。本研究比较了给予和未给予全身肝素化的结果。方法。对2008年4月至2012年11月期间连续的186例LDN患者进行回顾性分析。向供者静脉注射全身肝素（2000 - 3000国际单位）（肝素组n = 109）。从2010年1月起，该组LDN患者未全身使用肝素（无肝素组n = 77）。观察指标包括供者和受者的并发症、移植肾初始功能以及移植肾12个月生存率。结果。肝素化和未肝素化供者的人口统计学特征相似。两组的热缺血时间（WIT）相当（WIT；肝素组5 ± 3分钟 vs 无肝素组5 ± 3分钟；P = 1.000）。两组在并发症发生率、无移植肾血栓形成事件以及无原发性无功能发生率方面均无差异。移植肾功能延迟恢复分别发生在4/109和1/77例患者中（3.6% 对 1.2%；P = 0.405），移植肾生存率也无显著差异（P = 0.650）。结论。在腹腔镜供肾肾切除术中省略全身肝素化是一种可行且安全的方法，不会影响供者或受者的结局。
