Bay W H, Hebert L A
Ann Intern Med. 1987 May;106(5):719-27. doi: 10.7326/0003-4819-106-5-719.
Kidney transplantation using either kidneys from living or nonliving donors is now generally regarded as the primary therapy for most patients with end-stage kidney failure. In 1984, 32% of all kidney transplantations done in the United States involved living donors. Reasons justifying the use of kidneys from living donors are the higher success rate and the inadequate supply of cadaveric kidneys. In addition, with a living donor, it is easier to arrange for kidney transplantation before dialysis therapy needs to be started. An analysis of 2495 donor nephrectomies reported in the literature, and 5698 donor nephrectomies reported from the 12 largest centers that do kidney transplantation with living donors, indicates an approximate incidence of 1 donor death per 1600 nephrectomies. Although long-term follow-up in kidney donors has shown only that mild, nonprogressive proteinuria develops in about 33% and that the frequency of hypertension may increase, we advise that the kidney donor have a careful long-term follow-up and avoid a high protein intake because of its potential to lead to progressive glomerular damage.
使用活体或非活体供体的肾脏进行肾移植，目前通常被视为大多数终末期肾衰竭患者的主要治疗方法。1984年，在美国进行的所有肾移植手术中，32%涉及活体供体。使用活体供体肾脏的理由是成功率更高以及尸体肾脏供应不足。此外，对于活体供体，在需要开始透析治疗之前更容易安排肾移植。对文献报道的2495例供体肾切除术以及12个进行活体供体肾移植的最大中心报道的5698例供体肾切除术进行分析，结果表明每1600例肾切除术中约有1例供体死亡。尽管对肾脏供体的长期随访仅显示约33%的供体出现轻度、非进行性蛋白尿，且高血压发生率可能增加，但我们建议对肾脏供体进行仔细的长期随访，并避免高蛋白摄入，因为高蛋白摄入可能导致进行性肾小球损伤。
