Abdellaoui Imen, Azzabi A, Sahtout W, Sabri F, Hmida W, Achour A
Nephrology, Dialysis and Transplantation Department, Sahloul University Hospital of Sousse, Tunisia.
Urology Department, Sahloul University Hospital of Sousse, Tunisia.
Saudi J Kidney Dis Transpl. 2019 Mar-Apr;30(2):401-420. doi: 10.4103/1319-2442.256848.
Living-donor kidney transplantation is a well-established treatment of end-stage renal disease in Tunisia. Over the years, concerns have increased about the harmlessness of kidney donation. This longitudinal single center study was carried out to evaluate the safety of nephrectomy as well as further medical and surgical outcomes among donors. We collected and analyzed clinical, biological, biochemical and kidney size data at the time of nephrectomy and at M1, M3, M6, Y1, Y2, and Y4 after donation measured by ultrasound. All donor nephrectomies performed in the nephrology and transplantation unit of Sahloul Hospital of Sousse since October 2006 were included. Criteria of exclusion were lost to follow-up or lack of complete data. Of the 106 donors (66 females and 40 males), 92 donors were included in the follow-up analysis after following exclusion criteria. The mean age at the time of nephrectomy was 42.8 ± 10 years with the sex ratio 0.6. and 27% of our donors were mothers. Twenty-two percent of the donors were obese and 4% were hypertensive. The median initial glomerular filtration rate (GFR) was 105 mL/min/1.73 m. The surgical approach was costal lumbotomy in 96% of cases and laparoscopy for four cases. The kidneys were removed from the left side in 93% of cases. Postoperative mortality was zero and early postoperative morbidity was low. The median duration of hospital stay was nine days. During follow-up, 14% attended all recommended visits. The median follow-up duration was 26 months. After two years post donation, the prevalence of HTN was 28% and obesity was 26%. The prevalence of GFR decline (50-59 mL/min) was 14% using formula by modification of diet in renal disease. None of our donors reached stage 4 or 5 CKD. Twelve had proteinuria and one donor had diabetes, a comparable prevalence of morbidities to the general population.
活体供肾移植在突尼斯是一种成熟的终末期肾病治疗方法。多年来，人们对肾脏捐赠的无害性越来越关注。本纵向单中心研究旨在评估供体肾切除术的安全性以及进一步的医学和手术结局。我们收集并分析了肾切除时以及捐赠后通过超声测量的M1、M3、M6、Y1、Y2和Y4时的临床、生物学、生化和肾脏大小数据。纳入了自2006年10月以来在苏塞萨尔胡勒医院肾脏病与移植科进行的所有供体肾切除术。排除标准为失访或缺乏完整数据。106名供体（66名女性和40名男性）中，92名供体在遵循排除标准后纳入随访分析。肾切除时的平均年龄为42.8±10岁，性别比为0.6。27%的供体为母亲。22%的供体肥胖，4%的供体患有高血压。初始肾小球滤过率（GFR）中位数为105 mL/min/1.73 m²。96%的病例手术方式为肋下腰部切口，4例为腹腔镜手术。93%的病例肾脏从左侧切除。术后死亡率为零，术后早期发病率较低。住院时间中位数为9天。随访期间，14%的人参加了所有推荐的就诊。随访时间中位数为26个月。捐赠后两年，高血压患病率为28%，肥胖患病率为26%。根据肾脏病饮食改良公式，GFR下降（50 - 59 mL/min）的患病率为14%。我们的供体均未达到4期或5期慢性肾脏病。12人有蛋白尿，1名供体患有糖尿病，其发病率与普通人群相当。
