摘要
背景:活体供肾肾移植关系到供受者双方的生命,要求手术确保供受者安全,手术风险大,技术要求高,为保证供者的安全,如何选择供肾的切取方式十分关键。目的:总结37例经背腰十二肋切口亲属活体供肾切取术的临床经验,评价其效果及安全性。方法:选择广西中医学院附属瑞康医院移植泌尿外科2007-06/2008-08完成亲属活体供肾移植患者40例,其中37例采用经背腰十二肋小切口术式切取亲属活体供肾,回顾分析供、受者相关的临床资料。同期随机抽取尸肾移植40例,将亲属活体间肾移植受者与尸肾移植受者在血肌酐水平恢复正常时间、急性排斥反应发生率、肾功能延迟恢复发生率、外科相关并发症发生率等方面进行比较。结果与结论:37例手术均成功,供肾切取手术时间仅1.0～2.0h,供肾热缺血时间约15s,冷缺血时间1.0～2.0h,术中出血不多,围手术期间未发生外科及内科并发症。受者术后肾功能恢复快,1周左右血肌酐水平均可降至正常。随访至今,所有供、受者均正常生存,移植肾功能均保持在正常范围。活体肾移植受者在血肌酐水平恢复正常时间、急性排斥反应发生率、肾功能延迟恢复发生率等方面均显著低于尸肾移植。提示经背腰十二肋切口开放切取供肾手术除了有手术时间、热缺血时间短等优点外,在手术安全性方面也有一定的优势,亲属活体肾移植供肾质量高,术后人/肾存活率高。
BACKGROUND：Living donor kidney transplantation has relationship with both lives of donors and recipients.It is required that operation for donor and recipient should be ensured to be successful.Because of large operation risk and high technical requirements,it is critical to choose the cutting method of donor kidney,in order to ensure the donor＇s safety.OBJECTIVE：To summarize the clinical experiences about 37 cases of the 12th-rib supracostal incision through back and waist in relative living donor kidney cutting technique,and to evaluate its effect and reliability.METHODS：Totally 40 operations of relative living donor kidney transplantation have been completed at the Department of urinary surgery,RuiKang Hospital Affiliated to Guangxi Chinese Traditional Medicine College,from June 2007 to August 2008.Among the 40 operations,there were 37 operations adopting the 12th-rib supracostal incision technique to cut and take relative living donor kidney.The relevant clinical data of the donors and the recipients were reviewed and analyzed.Meantime,40 cases received cadaveric renal transplantation at corresponding time periods were selected as controls.The differences of recovery times of serum creatinine,occurrence rates of acute rejection,delayed graft function,related complication were compared.RESULTS AND CONCLUSION：The operation was successful in all 37 cases.The operating times of all donors were 1.0-2.0 hours,the warm ischemic time of donor kidney was about 15 seconds,and the cold ischemic times were 1.0-2.0 hours.No much haemorrhage occurred during the process of operation.No surgical complication and medical complication occurred during the peri-operation period.The kidney function of recipient recovered rapidly after operation.All of the creatinine levels could be restored to normal in 1 week.Up till now,all donors and recipients survived.Moreover,the functions of transplanted kidney were in normal range.Compared with the 40 cases with cadaveric kidney transplantation in the same period,the donors of l
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第53期9991-9994,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
基金
广西自然科学基金项目(2010GXNSFA013218)~~
