中国组织工程研究与临床康复2009，Vol.13Issue(44)：8729-8732,4.DOI:10.3969/j.issn.1673-8225.2009.44.029
亲属活体肾移植供者选取策略及围手术期的处理体会
Donor selective strategies and perioperative treatment in living related kidney transplantation
余少杰 1彭龙开 1谢续标 1彭风华 1王彧 1蓝恭斌1
作者信息
- 1. 中南大学湘雅二医院,湖南省长沙市,410011
- 折叠
摘要
Abstract
OBJECTIVE:To investigate the donor selective strategies and perioperative treatment in living related kidney transplantation.METHODS:126 donors and recipients of relative living donor kidney transplantation in Second Xiangya Hospital,Central South Universitywere enrolled in our study.Among the 126 donors,there were 32 males and 94 females,aging from 28 to 64 years.There were 61 cases of parents to children,56 cases of donors to siblings,6 cases of donors to their spouses,1 case of son to father,1 case of nephew to uncle,and 1 case of mother-in-law to son-in-law.The details of surgical process and postoperational recovery of the 126 cases of living donors were retrospectively summarized and analyzed.RESULTS:One recipient developed delayed graft function(DGF);2 recipients were diagnosed with acute rejection,which was reversed by antilymphocyte globulin injection;1 donor was complicated with intestinal obstruction and finally recovered from conservative treatment;1 donor developed obstructive pneumonia due to intolerance of expectoration induced wound pain,and was controlled after certain drugs were administrated to reduce phlegm and bronchofiberscope was used to aspirating sputum,usage time of antibiotics were appropriately prolonged;spirometra mansoni was found in 1 donor's perirenal fatty capsule.Praziquantel was routinely taken by both donor and recipient.After 1 year's follow up,the blood eosinocytes were at normal level and no abnormality was found in perirenal ultrasonography;there were 3 cases of donor kidney calculus,and 2 cases of the recipients maintained normal renal function with stable stone volume in 2 years' follow-up,while oliguria suddenly occurred in 1 case of the recipient in the 9~(th) month post transplantation,percutaneous nephrolithotomy and holmium laser were used to break the stone,and renal function turned to normal with no residual calculus found in the graft;5 cases of donors were found one-side renal cyst in preoperative CT scanning,and all the cysts were moved during surgical operation,ultrasonography was routinely used in posttransplantational follow-up,and no new cyst was found either in the graft or in the donor's solitary kidney(mean 3 years of follow-up);1 case of donor did not follow the doctor's advice and lived intemperately,who was diagnosed pulmonary tuberculosis in 3 months of follow-up,then he received treatment in tuberculosis hospital but he died from sudden death,and autopsy was denied by his family member.Almost all of the donors underwent transient elevation of blood serum creatinine,but returned to normal standard in long-term follow-up.CONCLUSION:The strategy of living related donor should be selected based on comprehensive evaluation,and" no harm to donor" is the primary principle.关键词
亲属活体肾移植/肾切除术/供者分类
临床医学引用本文复制引用
余少杰,彭龙开,谢续标,彭风华,王彧,蓝恭斌..亲属活体肾移植供者选取策略及围手术期的处理体会[J].中国组织工程研究与临床康复,2009,13(44):8729-8732,4.
