Toronyi E, Alföldy F, Járay J, Remport A, Hidvégi M, Dabasi G, Telkes G, Offenbacher E, Perner F
Semmelweis Medical University, Transplantation and Surgical Department, Budapest, Hungary.
Transpl Int. 1998;11 Suppl 1:S57-9. doi: 10.1007/s001470050426.
Renal transplantation is the optimal mode of therapy for patients with end-stage renal disease; the results are even better with living related donors. This procedure, therefore, favours the recipients, but what are the consequences for the donor? At our Department, between 1973 and 1996, 1325 kidney transplantations were performed, 78 from living, related donors (5.89%). We decided to follow up these patients and investigate the function of the remaining kidney and also their current general health status. Thirty donors (38.4%) were investigated. Of these, 25 of had normal blood pressure and 5 were hypertensive, needing antihypertensive treatment. The average age was higher in the hypertensive group (60.2/53.25 years). The time interval since transplantation was longer in the hypertensive group than in the normal one. We carried out a scintigraphy of the kidney with Tc-99mMAG-3. The mean value of the glomerular filtration rate calculated from the MAG clearance was 98.1 ml/min and this value is higher than half of the normal isotope clearance value, i.e. higher then the expected value for a single kidney. We conclude that no impairment of renal function is observed in the living, related kidney donors. In 16.66% a mild hypertension developed. With isotope investigation we found hypertrophy of the remaining kidney. Thus, after a correct preoperative assessment, unilateral nephrectomy has no long-term consequences in healthy donors.
肾移植是终末期肾病患者的最佳治疗方式；对于活体亲属供肾者而言，治疗效果更佳。因此，该手术对受者有益，但对供者会有什么影响呢？在我们科室，1973年至1996年间共进行了1325例肾移植手术，其中78例来自活体亲属供者（5.89%）。我们决定对这些患者进行随访，调查其剩余肾脏的功能以及他们目前的总体健康状况。对30名供者（38.4%）进行了调查。其中，25名供者血压正常，5名供者患有高血压，需要进行降压治疗。高血压组的平均年龄更高（60.2/53.25岁）。高血压组自移植后的时间间隔比正常组更长。我们用Tc-99mMAG-3对肾脏进行了闪烁扫描。根据MAG清除率计算出的肾小球滤过率平均值为98.1毫升/分钟，该值高于正常同位素清除率值的一半，即高于单肾的预期值。我们得出结论，在活体亲属供肾者中未观察到肾功能受损。16.66%的供者出现了轻度高血压。通过同位素检查，我们发现剩余肾脏肥大。因此，经过正确的术前评估，单侧肾切除术对健康供者没有长期影响。
