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腹主动脉后静脉是否为腹腔镜活体供肾切除术的危险因素?

Is a Retroaortic Vein a Risk Factor in Laparoscopic Living Donor Nephrectomy?

机构信息

Department of Urology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.

Department of Nephrology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.

出版信息

Urol Int. 2020;104(7-8):641-645. doi: 10.1159/000507642. Epub 2020 May 15.

Abstract

INTRODUCTION

In living donor transplantation choosing the right donor and donor side for laparoscopic donor nephrectomy is a challenging task in clinical practice. Knowledge about anomalies in renal blood supply are crucial to evaluate the feasibility of the operative procedure. Few data so far exist whether the existence of a retroaortic left renal vein has an impact on living kidney transplantation outcome for donor and recipient.

MATERIALS AND METHODS

We retrospectively analyzed 221 patients who underwent laparoscopic living donor nephrectomy between 2011 and 2017 for existence of a retroaortic left renal vein. Clinical characteristics and operative outcomes for donors and recipients were analyzed.

RESULTS

221 patients underwent donor nephrectomy between 2011 and 2017; 11 patients (4.98%) showed the feature of a retroaortic left renal vein, and in 8 patients (72.7%) out of those 11 the left kidney was chosen for transplantation. Mean preoperative serum creatinine was 0.77 (0.49-0.98) mg/dL and 1.28 (0.97-1.64) mg/dL at discharge. In recipients mean serum creatinine preoperatively, after 1 week, 1 month,1 year, 2 and 3 years of follow-up was 10.36 (6.09-20.77) mg/dL, 1.71 (0.67-2.72), 1.33 (0.70-1.89), 1.31 (0.95-2.13), 1.31 (0.98-2.13) and 1.33 (1.03-1.84), respectively. Neither donors nor recipients suffered from any operative complications.

CONCLUSIONS

Laparoscopic living donor nephrectomy of a left kidney with retroaortic renal vein is safe for the donor, without limitation in the outcome for the recipient.

摘要

介绍

在活体供者移植中,选择合适的供者和供者侧进行腹腔镜供者肾切除术是临床实践中的一项具有挑战性的任务。了解肾血供异常对于评估手术可行性至关重要。目前关于是否存在主动脉后左侧肾静脉对供者和受者活体肾移植结果有影响的数据很少。

材料与方法

我们回顾性分析了 2011 年至 2017 年间 221 例行腹腔镜活体供肾切除术的患者,以确定是否存在主动脉后左侧肾静脉。分析了供者和受者的临床特征和手术结果。

结果

2011 年至 2017 年间,221 例患者接受了供肾切除术;11 例(4.98%)患者存在主动脉后左侧肾静脉,其中 8 例(72.7%)患者选择左侧肾脏进行移植。术前血清肌酐均值为 0.77(0.49-0.98)mg/dL,出院时为 1.28(0.97-1.64)mg/dL。受者术前、术后 1 周、1 个月、1 年、2 年和 3 年的血清肌酐均值分别为 10.36(6.09-20.77)mg/dL、1.71(0.67-2.72)mg/dL、1.33(0.70-1.89)mg/dL、1.31(0.95-2.13)mg/dL、1.31(0.98-2.13)mg/dL 和 1.33(1.03-1.84)mg/dL。供者和受者均未发生任何手术并发症。

结论

腹腔镜活体供者肾切除术切除主动脉后左侧肾静脉的供者是安全的,对受者的结果没有限制。

相似文献

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Anatomical Variations of the Left Renal Vein During Laparoscopic Donor Nephrectomy.腹腔镜供肾切除术期间左肾静脉的解剖变异
Transplant Proc. 2019 Jun;51(5):1311-1313. doi: 10.1016/j.transproceed.2019.01.132. Epub 2019 Apr 26.

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