Aboalsamh Ghaleb Anas, Khalil Muhammad Abdul Mabood, Sadagah Nihal Mohammed, Mahmood Hinda Hassan Khideer, Basha Ahmed Abdelahad, Ahmed Mohamed Abdelmonem Said, Cruz Aileen Jean Dela, Sakran Hisham Ismael Mohamed, Assiri Ibrahim Mohammed Nasser, Al-Qurashi Salem H
Center of Renal Diseases and Transplantation, King Fahad Armed Forces Hospital, Al Kurnaysh Br Rd, Al Andalus, Jeddah 23311, Saudi Arabia.
J Transplant. 2025 Jun 25;2025:1694242. doi: 10.1155/joot/1694242. eCollection 2025.
Live kidney donation is increasingly common due to the shortage of organs. Surgeons prefer the left kidney due to easier access and longer renal vein. There are conflicting reports about the outcomes of right versus left kidney transplants. The objective of this study was to compare the immediate and long-term outcomes of right and left kidney recipients in live donor kidney transplants. A retrospective analysis of 215 live kidney donors from 2021 to 2023 was conducted to compare outcomes between the recipients of right and left kidneys. Data were collected on donor and recipient demographics, surgical outcomes, and complications. Baseline values were summarized using descriptive statistics, with the quantitative and qualitative data reported as means, medians, interquartile ranges, standard deviations, and frequencies. Differences between the groups were analyzed using the Chi-square test and -test. Among the 215 donors, 141 (65.6%) were male and 74 (34.4%) were female, with a mean nuclear GFR of 105.89 ± 10.91 mL/min. Left kidneys were donated in 176 cases (81.9%), and right kidneys in 39 cases (18.1%). The most common complications were delayed graft function (DGF) in 15 cases (6.9%), hematoma in six cases (2.7%), seroma in nine cases (4.2%), and rejection in 10 cases (4.7%). There were no significant differences between the groups for gender, cold ischemia time, operation time, hospital stay, intraoperative hemorrhage, blood transfusion, re-exploration, hematoma, seroma, urine leak, or the presence of donor-specific antibodies (DSA), BK or cytomegalovirus viremia, rejections, or death-censored graft loss. Right nephrectomies and re-exploration were identified as independent predictors of DGF. Creatinine levels and estimated glomerular filtration rates at discharge, 6 months, 1 year, and 2 years did not differ significantly between the recipients of the right and left kidneys. Laparoscopic left and right donor nephrectomies show comparable long-term outcomes with no significant differences in creatinine levels at 6 months, 1 year, and 2 years post-transplantation. Despite more DGF in right kidney recipients, both kidneys are suitable for transplantation without compromising long-term outcomes. These findings highlight the feasibility of utilizing the right kidney for donation when required.
由于器官短缺，活体肾捐赠日益普遍。由于更容易获取且肾静脉更长，外科医生更喜欢左肾。关于右肾移植与左肾移植的结果存在相互矛盾的报道。本研究的目的是比较活体供肾移植中右肾和左肾受者的近期和长期结果。对2021年至2023年的215名活体肾供者进行回顾性分析，以比较右肾和左肾受者的结果。收集了供者和受者的人口统计学数据、手术结果及并发症数据。使用描述性统计总结基线值，定量和定性数据分别报告为均值、中位数、四分位间距、标准差和频率。使用卡方检验和t检验分析组间差异。在215名供者中，141名（65.6%）为男性，74名（34.4%）为女性，平均核滤过率为105.89±10.91毫升/分钟。176例（81.9%）捐赠左肾，39例（18.1%）捐赠右肾。最常见的并发症为移植肾功能延迟恢复（DGF）15例（6.9%）、血肿6例（2.7%）、血清肿9例（4.2%）、排斥反应10例（4.7%）。两组在性别、冷缺血时间、手术时间、住院时间、术中出血、输血、再次探查、血肿、血清肿、尿漏或供者特异性抗体（DSA）、BK或巨细胞病毒血症、排斥反应或死亡审查的移植肾丢失情况方面无显著差异。右肾切除术和再次探查被确定为DGF的独立预测因素。右肾和左肾受者出院时、6个月、1年和2年时的肌酐水平及估计肾小球滤过率无显著差异。腹腔镜下左、右供肾切除术显示出可比的长期结果，移植后6个月、1年和2年时肌酐水平无显著差异。尽管右肾受者的DGF更多，但两个肾脏都适合移植，且不影响长期结果。这些发现突出了在需要时利用右肾进行捐赠的可行性。
