Living related donor kidney transplantation:clinical analysis for 30 cases / 解放军医学杂志

ABSTRACT

Objective To analyze the clinical data of living related donor kidney transplantation,and to evaluate the related problems including the donor selection and safety,the surgical approach of living donor nephrectomy,preoperative intervention,and the relation of type matching with transplantation result.Methods Data of 30 cases of living donor kidney transplantation during 07/2002 to 07/2007 were studied retrospectively.29 cases were primary transplantation and only in one patient the transplantation was repeated,2 patients secured their transplants from the spouse,while in 28 cases transplants were donated by relatives.The blood type of all the patients was identical with an exception in 2 cases,in whom the blood type was compatible.The HLA matching results were1 case with no-mismatch,3 cases with 4-loci mismatch,13 cases with 2-loci mismatch and 13 cases with 1-locus mismatch.The kidney was obtained with open nephrectomy in 21 cases,and in 9 donors the was harvested laparoscopically.In the 30 cases,one right kidney was donated,and the left kidneys were donated in other 29 cases.Triple-combined immunosuppressive protocols consisted of calcineurin inhibitors(CNI),MMF/Aza and steroid.Results Except in one case the allograft was removed for hyperacute rejection,and in one recipient who was again retransplanted with a cadaveric kidney due to dysfunction of transplanted kidney,28 recipients recovered smoothly in 6.3?8.0 days.In 4 cases infection with cytomegalovirus after the surgery occurred,but recovered after anti-virus treatment with ganciclovir.One patient suffered from urinary leakage,and recovered after adequate drainage,nutritional support and infection prevention.Two patients suffered from acute rejection in the first month after transplantation and reversed after hormone stosstheraphy.All donors recovered.The renal function also recovered.Conclusion Both the strict selection of donor and the overall preoperative evaluation of the donor and recipient are critical for the success of transplantation.Living relative donor kidney transplantation is worth of popalarizing,as it has preferable HLA match,short waiting time and renal ischemia time,and the source of donor kidney is expanded.