一项回顾性研究，旨在评估肯雅塔国家医院亲属活体肾供体的评估情况及其肾切除术后的结果。
A retrospective study to assess the evaluation of living related kidney donors and their outcomes following nephrectomy at Kenyatta National Hospital.
作者信息
Muturi A, Kotecha V, Kanyi S
机构信息
University of Nairobi, Nairobi, Kenya.
Department of Surgery Kenyatta National Hospital, Nairobi, Kenya.
出版信息
BMC Nephrol. 2017 May 25;18(1):171. doi: 10.1186/s12882-017-0585-7.
BACKGROUND
Kidney transplantation is the renal replacement therapy of choice for end stage renal disease. To ensure safety regular audit of the donation process is necessary. The aim of this study was to assess the evaluation of potential living related kidney donors and document their outcomes following nephrectomy.
METHODS
This was a retrospective descriptive study involving all living related kidney donors seen at Kenyatta National Hospital (KNH) renal unit from 2010 to 2014. Upon approval by KNH/ERC, the records of all kidney donors were retrieved. Demographic characteristics, number of potential and actual donors, their clinical, laboratory and radiological data as well as documented complications and deaths were recorded. SPSS version 17(Chicago, Ilinois) was used for data entry and analysis. Chi square test and Mann Whitney U test were used as tests of association for categorical and continuous data respectively, with P value set at <0.05.
RESULTS
Median age of the donors was 34 years (IQR 31-39). First-degree relatives were majority(84.5%). Renal function assessment was done using mean glomerular filtration rate (GFR) from the radionuclide scan (DTPA) and serum creatinine levels. The donors had a mean GFR of 99.2 ± SD 6.6. All the haematological and biochemical tests were within normal. Majority(42.9%) were HLA compatible, but data on HLA typing was missing for 22% of the patients records. On CT angiogram, single renal artery and single renal vein were found in 94 and 88% respectively. Immediate complications included excessive bleeding(2%) and breach of other cavities (4%). Paralytic ileus (32%) and atelectasis (27%) were the most common early postoperative complications. There was no mortality.
CONCLUSION
Our study reports no fatality but significant post-operative complications. These are significant findings that may be used to review and improve care and to educate potential kidney donors on the safety of this procedure in our centre, in a bid to widen the pool of potential living kidney donors.
背景
肾移植是终末期肾病首选的肾脏替代治疗方法。为确保安全，对捐赠过程进行定期审核很有必要。本研究的目的是评估潜在的活体亲属肾供体的评估情况，并记录他们肾切除术后的结果。
方法
这是一项回顾性描述性研究，纳入了2010年至2014年在肯雅塔国家医院（KNH）肾科就诊的所有活体亲属肾供体。经KNH/ERC批准后，检索了所有肾供体的记录。记录了人口统计学特征、潜在和实际供体的数量、他们的临床、实验室和放射学数据以及记录在案的并发症和死亡情况。使用SPSS 17版（伊利诺伊州芝加哥）进行数据录入和分析。卡方检验和曼-惠特尼U检验分别用于分类数据和连续数据的关联性检验，P值设定为<0.05。
结果
供体的中位年龄为34岁（四分位间距31 - 39岁）。一级亲属占大多数（84.5%）。使用放射性核素扫描（二巯基丁二酸）的平均肾小球滤过率（GFR）和血清肌酐水平进行肾功能评估。供体的平均GFR为99.2±标准差6.6。所有血液学和生化检查均在正常范围内。大多数（42.9%）为HLA配型相合，但22%的患者记录中缺少HLA分型数据。在CT血管造影上，分别有94%和88%发现单支肾动脉和单支肾静脉。即刻并发症包括出血过多（2%）和其他腔隙破裂（4%）。麻痹性肠梗阻（32%）和肺不张（27%）是最常见的术后早期并发症。无死亡病例。
结论
我们的研究报告没有死亡病例，但有显著的术后并发症。这些是重要的发现，可用于审查和改善护理，并就该手术在我们中心的安全性对潜在的肾供体进行教育，以扩大潜在活体肾供体的群体。
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