Nakamura Nobuyuki, Aoyagi Chikao, Matsuzaki Hiroshi, Furuya Ryusaburo, Irie Shinichiro, Matsuoka Hirofumi, Tanaka Masatoshi
Department of Urology, Fukuoka University Hospital, Fukuoka City, Fukuoka, Japan.
Department of Urology, Fukuoka University Hospital, Fukuoka City, Fukuoka, Japan.
Transplant Proc. 2019 Jun;51(5):1314-1316. doi: 10.1016/j.transproceed.2019.01.130. Epub 2019 May 2.
Renal scintigraphy is used to evaluate split renal function. A computed tomography (CT) examination is also carried out for donor safety and appropriate transplantation surgery, and the renal volume (CT volumetry) can be obtained at that time. In this study, we evaluated donor kidney function by inulin clearance (Cin) before and after donor nephrectomy in living donor renal transplantation, and the predictive role of CT volumetry was compared with diethylenetriamine pentaacetic acid (DTPA).
From November 2005 to April 2018, 34 cases of living donor transplantation conducted at Fukuoka University Hospital were retrospectively studied. The donated kidney weight was measured in 25 cases, and postoperative Cin was measured in 19 cases.
The average donor age was 51.7 years old (from 35 to 71). Preoperative Cin and postoperative Cin of donors were 86.3 mL/min/1.73 m (from 59.5 to 138.3) and 52.3 (from 40.5 to 76.6), respectively. The average CT volumetry of donated kidneys was 153.9 mL (from 107.8 to 219.3). Correlations of weight and DTPA and CT volumetry of donated kidneys were r = 0.033 (P = .8770) and r = 0.763 (P < .0001), respectively. Correlations of glomerular filtration rate of DTPA and CT volumetry and Cin of postoperative donor residual kidneys were r = 0.66 (P = .002) and r = 0.555 (P = .014).
There was a significant correlation between CT volumetry and the weight of the removed kidneys, and a correlation between Cin after donor nephrectomy and CT volumetry of the remaining kidneys, but it did not exceed the predictive role of DTPA. However, it was suggested that it is worthy to use as a preoperative examination for split renal function equivalent to DTPA.
肾闪烁扫描术用于评估分肾功能。为确保供体安全及进行合适的移植手术，还会进行计算机断层扫描（CT）检查，此时可获得肾脏体积（CT容积测量）。在本研究中，我们通过菊粉清除率（Cin）评估活体供肾移植中供体肾切除术前和术后的供体肾功能，并将CT容积测量与二乙三胺五乙酸（DTPA）的预测作用进行比较。
回顾性研究2005年11月至2018年4月在福冈大学医院进行的34例活体供体移植病例。测量了25例供肾重量，19例测量了术后Cin。
供体平均年龄为51.7岁（35至71岁）。供体术前Cin和术后Cin分别为86.3 mL/min/1.73 m²（59.5至138.3）和52.3（40.5至76.6）。供肾平均CT容积测量值为153.9 mL（107.8至219.3）。供肾重量与DTPA以及CT容积测量的相关性分别为r = 0.033（P = 0.8770）和r = 0.763（P < 0.0001）。术后供体残余肾DTPA的肾小球滤过率与CT容积测量以及Cin的相关性分别为r = 0.66（P = 0.002）和r = 0.555（P = 0.014）。
CT容积测量与切除肾脏的重量之间存在显著相关性，供肾切除术后Cin与剩余肾脏的CT容积测量之间也存在相关性，但未超过DTPA的预测作用。然而，提示其作为等同于DTPA的分肾功能术前检查是值得的。
