单中心亲属肾移植术后供者长期安全性分析  

Long-term donor safety analysis after related renal transplantation in a single center

作　　者：王纪渊 陈瑜 杨璟辉 郑鱈洋 丁越 韩澍 WANG Jiyuan;CHEN Yu;YANG Jinghui;ZHENG Xueyang;DING Yue;HAN Shu(Department of Organ Transplantation,The Second Affiliated Hospital of Naval Medical University(Second Military Medical University),Shanghai 200003,China)

机构地区：[1]海军军医大学(第二军医大学)第二附属医院器官移植科,上海200003

出　　处：《海军军医大学学报》2024年第11期1390-1394,共5页Academic Journal of Naval Medical University

摘　　要：目的评价亲属供肾者切除一侧肾脏后的长期安全性。方法采用门诊、电话及微信等随访方式,对91例于2006-2011年在我院接受亲属供肾切除术的供者进行至少10年的随访。在随访期间,对供者的血肌酐、血尿酸、血尿素氮、估计的肾小球滤过率(eGFR)、血尿、尿蛋白、血压、血糖和血脂等指标进行检测,分析供者供肾切除手术前后上述指标的变化。结果术后1个月,供者的血肌酐、血尿素氮、血尿酸水平均较术前升高(均P<0.05),但均处于正常参考值范围内。继续随访至术后1、3、5、10年,与术后1个月相比,供者血肌酐、血尿素氮、血尿酸水平相对稳定(均P>0.05)。不同年龄段供者的eGFR术后长期保持相对稳定。供者术后出现镜下血尿3例、蛋白尿4例,经过休息、对症治疗后均有所好转。10例(11.0%)供者术后发生高血压,5例(5.5%)发生高脂血症,5例(5.5%)发生糖尿病,无死亡患者。结论对于健康的亲属供者,供肾切除手术安全、可行。但为确保亲属供者的安全,供肾切除术前的全面评估和术后的定期规律随访至关重要。Objective To evaluate the long-term safety of related kidney donors after unilateral nephrectomy.Methods A total of 91 related donors who received nephrectomy in our hospital from 2006 to 2011 were followed up for at least 10 years by outpatient,telephone,or WeChat.During the follow-up period,the serum creatinine,serum uric acid,blood urea nitrogen,estimated glomerular filtration rate(eGFR),hematuria,urinary protein,blood pressure,blood glucose and blood lipids of the donors were detected,and the changes before and after nephrectomy were analyzed.Results At 1 month after operation,the levels of serum creatinine,blood urea nitrogen and serum uric acid of the donor were significantly higher than those before operation(all P<0.05),but still within the normal range.The patients were followed up for 1,3,5 and 10 years after operation.Compared with 1 month after operation,the serum creatinine,blood urea nitrogen and serum uric acid were relatively stable(all P>0.05).The eGFR of donors of different ages remained relatively stable for a long time after operation.There were 3 cases of endoscopic hematuria and 4 cases of proteinuria after surgery,and these symptoms were relieved after rest and symptomatic treatment.Ten(11.0%)donors developed hypertension 5(5.5%)developed hyperlipidemia,and 5(5.5%)developed diabetes mellitus.No patient died.Conclusion Nephrectomy is safe and feasible for healthy related donors.To ensure the safety of the donors,comprehensive evaluation before nephrectomy and regular follow-up after nephrectomy are essential.

关 键 词：活体亲属肾移植 肾供体 安全性 随访 

分 类 号：R699.2[医药卫生—泌尿科学]