先前活体肾捐献者的肾切除风险。

Risk of Nephrectomy in Previous Living Kidney Donors.

机构信息

1 Division of Urology, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. 2 Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. 3 Division of Urology, Department of Surgery, St. Joseph's Health Care, Western University, London, Ontario, Canada. 4 Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada. 5 Department of Medicine, Division of Nephrology, University of Alberta, Edmonton, Alberta, Canada. 6 Center for Outcomes Research and Center for Abdominal Transplantation, Saint Louis University, St. Louis, MO. 7 Department of Urologic Sciences, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada. 8 Department of Medicine, Division of Nephrology, Western University, London, Ontario, Canada.

出版信息

Transplantation. 2016 Jun;100(6):1313-7. doi: 10.1097/TP.0000000000001036.

DOI:10.1097/TP.0000000000001036

PMID:26683516

Abstract

BACKGROUND

For patients with a solitary kidney, such as living kidney donors, the surgical treatment of renal tumors may result in loss of function of the remaining kidney.

METHODS

We conducted a retrospective, matched cohort study to determine the long-term risk of partial or total nephrectomy in previous living kidney donors compared to healthy nondonors. We reviewed the predonation charts for all living kidney donors in Ontario, Canada between 1992 and 2010 and linked this information to provincial healthcare databases.

RESULTS

We matched 2119 donors to 21190 nondonors from the general population with similar baseline health. The median length of follow-up was 9.5 years (maximum 21.7 years). The rate of nephrectomy in follow-up was lower in donors versus nondonors (0 vs. 1.78 per 10000 person years; P = 0.037). In a subset of 1773 donors matched to 1773 healthy nondonors with renal imaging (median follow-up 7.6 years, maximum 21.0 years), the rate of nephrectomy was not statistically different in donors versus nondonors (0 vs. ≤5 per 10000 person years; P > 0.08).

CONCLUSION

No living kidney donor in our cohort received a partial or total nephrectomy of their remaining kidney during our follow-up period. Although we will continue to follow people in this study, these interim results are reassuring for the safety of kidney donation.

摘要

背景

对于单侧肾脏的患者，如活体供肾者，肾肿瘤的手术治疗可能导致剩余肾脏功能丧失。

方法

我们进行了一项回顾性、匹配队列研究，以确定与健康非供体相比，先前的活体供肾者行部分或全部肾切除术的长期风险。我们回顾了加拿大安大略省 1992 年至 2010 年间所有活体供肾者的供肾前图表，并将这些信息与省级医疗保健数据库进行了关联。

结果

我们将 2119 名供体与来自普通人群的 21190 名非供体进行了匹配，这些非供体的基线健康状况相似。中位随访时间为 9.5 年（最长 21.7 年）。随访期间供体肾切除术的发生率低于非供体（0 比 1.78/10000 人年；P = 0.037）。在 1773 名供体与 1773 名有肾脏影像学检查的健康非供体的亚组中（中位随访 7.6 年，最长 21.0 年），供体与非供体的肾切除术发生率无统计学差异（0 比 ≤5/10000 人年；P > 0.08）。