摘要
目的观察亲属活体供者供肾前后肾功能的变化。方法102名供者均经过严格的术前筛选及评估，其中男性32名，女性70名，供肾时年龄为34-62岁，平均为51．7岁。采用腹腔镜切取供肾74例，开放手术切取供肾28例；其中取左肾90例，取右肾12例。术后对供者进行长期随访，收集术后1d、7d、14d、1个月、3个月、6个月及每年的随访检测资料，检测内容包括血常规、尿常规、血清肌酐（cr）和尿素氮（BUN）及肾小球滤过率（GFR）等，观察术后不同时期肾功能的变化情况，并与术前进行比较。结果102例亲属活体供肾切取术均获得成功，术后随访时间为3～99个月，平均37．8个月，供者均健在。供肾术后早期供者的血红蛋白和红细胞计数有所下降，但分别在术后1周和2周后恢复至术前水平；供者的血清Cr水平均有不同程度的升高（P〈0.05），但未超出正常范围；除术后第1天供者的血清BUN水平较术前有所升高外（P〈0．05），其他随访时间血清BUN水平与术前比较，差异均无统计学意义（P〉0．05）；术后供者的GFR较术前均有不同程度的升高，从术后2周开始，与术前比较，差异均有统计学意义（P〈0．05），其中以术后3个月时的增幅最大；术后各随访时间均未检测出尿蛋白定性呈阳性的供者。结论活体供肾后，供者的血清Cr水平虽较术前有不同程度的升高，但未超出正常范围，GFR呈代偿性增高，活体供肾是安全的。
Objective To investigate the changes of renal function in living related kidney donors. Methods 102 living related donor kidney transplantations were performed at our center from Jan. 2000 to Jan. 2008. All of the follow-up data were collected to investigate the changes of renal function in living related kidney donors. Living kidney donors underwent a comprehensive inspection pre- and post-operation, including blood regular test, serum creatinine, blood urea nitrogen, glomerular filtration rate and urine protein, and then regular followed-up after operation. All of the indexes were compared to themselves before operation. Results 102 operations were performed successfully, and none of the living related donors died. There were 32 male and 70 female donors with mean age of 51.7 years （34-62）. Nephreetomy on 90 left and 12 right sides was done. Seventy-four donors underwent laparoscopic nephrectomy and the others were subjected to open nephrectomy. All donors were followed up from 3 to 99 months （mean 37. 8 months）. The hemoglobin level was decreased post-operation and had significant difference on the first day, and first week compared to pre-operation. The RBC count had also significant difference within two weeks. The blood urea nitrogen level was increased significantly compared to preoperative level. There was significant difference in serum creatinine level before and after operation （P〈0. 05）, but none of the indexes exceeding normal range. After operation, GFR of donors was increased to varying degrees as compared with that before operation. Starting from the postoperative weeks 2, there was significant difference GFR in comparison to that before operation （P〈0. 05）. The rate of the increase in GFR at the 3rd month after operation was the largest. Urinary protein had no positive findings. Conclusion The renal function in living related kidney donors is not influenced after operation. The serum creatinine level is elevated to varying degrees after operation, but still within normal limit
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2009年第10期612-615,共4页
Chinese Journal of Organ Transplantation
关键词
肾移植
活体供者
肾功能
Kidney transplantation
Living donors
Renal function
