CAJ | 학술논문

目的探讨50岁以上亲属活体供肾移植供者的安全性. 方法 1993年4月至2007年12月行年龄>50(51～78)岁亲属活体供肾移植45例,同期年龄≤50岁供者62例作为对照组.比较2组供者手术前后SCr、GFR变化,手术并发症及术后随访情况. 结果供肾手术均获成功.2组供者术前SCr分别为(82.16±10.86)和(78.66±10.41)μmol/L,术后1周、1个月及12个月分别为(106.00±8.68)、(86.62±10.81)、(83.18±9.19)μmol/L和(103.89±9.29)、(85.65±7.42)、(80.32±8.89)μmol/L,组问比较差异均无统计学意义(P>0.05);2组术前GFR分别为(85.82±6.26)和(88.74±9.44)ml/min,术后1、12个月分别为(49.76±3.57)、(60.32±4.42)ml/min和(51.36±5.39)、(62.10±6.31)ml/min,组间比较差异均无统计学意义(P>0.05).2组供者术后平均住院时间分别为9及8 d.>50岁组术中发生胸膜损伤2例,术后切口疼痛、下腹部麻木感4例,切口脂肪液化1例;对照组发生胸膜损伤1例,术后切口疼痛、下腹部麻木感9例.>50岁组供者随访37(12～180)个月,肾功能正常.结论高龄不是亲属活体供肾绝对禁忌证,术前全面系统评估及术中仔细操作是高龄供者术后安全性的重要保证.
목적 탐토50세이상친속활체공신이식공자적안전성. 방법 1993년4월지2007년12월행년령>50(51～78)세친속활체공신이식45례,동기년령≤50세공자62례작위대조조.비교2조공자수술전후SCr、GFR변화,수술병발증급술후수방정황. 결과 공신수술균획성공.2조공자술전SCr분별위(82.16±10.86)화(78.66±10.41)μmol/L,술후1주、1개월급12개월분별위(106.00±8.68)、(86.62±10.81)、(83.18±9.19)μmol/L화(103.89±9.29)、(85.65±7.42)、(80.32±8.89)μmol/L,조문비교차이균무통계학의의(P>0.05);2조술전GFR분별위(85.82±6.26)화(88.74±9.44)ml/min,술후1、12개월분별위(49.76±3.57)、(60.32±4.42)ml/min화(51.36±5.39)、(62.10±6.31)ml/min,조간비교차이균무통계학의의(P>0.05).2조공자술후평균주원시간분별위9급8 d.>50세조술중발생흉막손상2례,술후절구동통、하복부마목감4례,절구지방액화1례;대조조발생흉막손상1례,술후절구동통、하복부마목감9례.>50세조공자수방37(12～180)개월,신공능정상.결론 고령불시친속활체공신절대금기증,술전전면계통평고급술중자세조작시고령공자술후안전성적중요보증.
Objective To explore the safety of the elderly donors in living related donor kidney transplantation. Methods Forty-five elderly donors (51 - 78 years,study group) who underwent ne-phrectomy for living related donor kidney transplantation from April 1993 to December 2007 were retrospectively investigated. Clinical data including serum creatinine (SCr), glomerular filtration rate (GFR) in pre-and post-operation, operation complications and hospital stay time were analyzed and compared with the control group(62 cases, the donors age were younger than 50 years). Results The operations of all living donors were successful. The SCr and GFR in pre-operation were (82.16 ± 10.86)μmol/L, (85. 82±6.26)ml/min(study group)and (78. 66±10. 41)μmol/L, (88. 74±9. 44) ml/min (control group) respectively. There were no significant differences in SCr and GFR between the groups at different time points (P>0. 05). The average hospitalization time was 9 days in study group and 8 days in control group. There were no severe perioperative complications and no renal function failure was found in long-term following-up in study group. Conclusions Age is not the absolute contraindication of donor for living related donor kidney transplantation. The preoperative evaluation and careful operation can ensure the safety of elderly donors.