亲属肾移植供者生活质量及影响因素调查

目的探讨亲属肾移植供者生活质量及相关影响因素,以选择对应的康复指导和护理措施．促使其生活方式改进,提高生活质量。方法采用生活质量量表（SF-36）评估亲属肾移植供者（供肾组）58人及健康人群（对照组）58人的生活质量,并对影响亲属肾移植供者生活质量的因素进行分析。结果亲属肾移植供者疼痛得分低于健康人群,总体健康状况得分高于健康人群（均P〈0．05）;其他各维度评分及生活质量总分与健康人群比较,差异无统计学意义（均P〉0．05）。文化程度、家庭月收入、社会福利、家庭支持及供者与受者关系是供肾者生活质量的影响因素（P〈0．05,P〈0．01）。结论经过严格筛选的亲属肾移植供者生活质量与正常人相似;文化程度、家庭月收入、社会福利、家庭支持及供者与受者关系是供肾者生活质量的影响因素。加强供肾后健康教育,提供有效的医疗社会保障,可改善供肾者的生活质量。     

亲属肾移植供者生活质量及影响因素调查

目的探讨亲属肾移植供者生活质量及相关影响因素,以选择对应的康复指导和护理措施,促使其生活方式改进,提高生活质量。方法采用生活质量量表(SF-36)评估亲属肾移植供者(供肾组)58人及健康人群(对照组)58人的生活质量,并对影响亲属肾移植供者生活质量的因素进行分析。结果亲属肾移植供者疼痛得分低于健康人群,总体健康状况得分高于健康人群(均P0.05);其他各维度评分及生活质量总分与健康人群比较,差异无统计学意义(均P0.05)。文化程度、家庭月收入、社会福利、家庭支持及供者与受者关系是供肾者生活质量的影响因素(P0.05,P0.01)。结论经过严格筛选的亲属肾移植供者生活质量与正常人相似;文化程度、家庭月收入、社会福利、家庭支持及供者与受者关系是供肾者生活质量的影响因素。加强供肾后健康教育,提供有效的医疗社会保障,可改善供肾者的生活质量。     

重返岗位对严重烧伤患者康复期生活质量的影响

目的探讨重返岗位对严重烧伤患者康复期生活质量的影响。方法将96例复诊的严重烧伤患者按是否重返岗住分为重返岗位组（n=43）和未重返岗位组（n=53），用生活质量综合评定问卷评价两组患者的生活质量总分和各维度因子分。结果重返岗位组的生活质量总分显著高于未重返岗位组（P〈0.05）；躯体功能、心理功能和社会功能等各因子分中睡眠与精力、躯体不适感、运动与感觉功能、正性情感、认知功能、自尊、工作与学习、业余娱乐生活、婚姻与家庭和生活质量总评得分重返岗位组显著高于未重返岗位组（P〈0．05，P〈0．01）。结论重返岗位能提高严重烧伤患者康复期的生活质量，能重返岗位可作为衡量严重烧伤患者的生活质量的重要指标。     

两种透析方式患者经济负担与生活质量的比较

目的 探讨血液透析（HD）、腹膜透析（PD）两种肾脏替代治疗的患者经济负担和生活质量。方法 针对我中心维持透析≥6个月的HD、PD患者,回顾性调查其年平均经济负担及现阶段生活质量。结果HD组和PD组的年平均透析费用分别为（75619±42008）元、（53408±6667）元,2组比较有统计学差异（P〈0．05）;HD组和PD组总的经济负担分别为（100403±44419）元、（79859±22209）元,2组比较有统计学差异（P〈0．05）。PD组在生活质量方面（总体健康、精神健康、情感职能、躯体疼痛以及肾病负担、社交质量、症状与不适、肾病影响、满意度）得分优于PD组。结论HD患者疾病经济负担高于PD患者。PD在生活质量的某些维度上优于HD,应进一步推广使用PD。     

117例亲属肾移植供者术后生活质量调查及多因素分析

目的 探讨亲属肾移植供者术后生活质量及相关影响因素,为提高供者术后生命质量提供参考依据.方法 运用横断面调查研究方法以统一印制的调查表对本中心2006-2008年所实施的1 17例亲属肾移植供者术后实施问卷调查,并以同期健康人群作为对照组.调查内容包括社会人口学特征、手术并发症、经济状况、对亲属活体肾移植知晓状况、家庭支持情况、医疗保障及社会福利、术后日常锻炼等,以中文版SF-36量表测定生活质量.以t检验、方差分析和逐步回归对每一种影响因素进行分析.结果 亲属肾移植供者心理健康高于健康人群(P＜0.05);生活质量总分及其他各维度评分与健康人群比较,差异无统计学意义(P均＞0.05).单因素分析时,年龄、文化程度、经济状况、体育锻炼等4种因素与生活质量的多个领域均有关系.进一步多因素分析,在排除了各因素之间的相互影响后,对供者术后生活质量的主要影响因素分别是文化程度、经济状况、体育锻炼(P＜0.05).结论 术前应从社会心理等多角度对供者进行严格筛选,良好的社会心理背景、必要的心理指导及术后定期随访是保障供者术后良好生活质量的关键.     

肝移植受者应对方式与生活质量相关性研究

目的探讨肝移植受者应对方式与其生活质量的相关性。方法采用便利抽样方法选取141例肝移植受者,用一般情况调查表、医学应对问卷(MCMQ)和简明健康调查表(SF-36)对肝移植受者进行调查。MCMQ得分采用Feifel调查数据作为常模进行比较,SF-36得分与四川省常模进行比较,并对肝移植受者应对方式与生活质量进行相关性分析。结果肝移植受者面对应对方式得分为(19.38±3.98)分,回避应对方式得分为(15.01±3.17)分,屈服应对方式得分为(8.01±2.67)分。回避方式得分显著高于Feifel常模(P=0.008),面对和屈服方式得分均显著低于Feifel常模(P=0.046和P=0.001)。肝移植受者生理健康生活质量(PCS)得分为(50.96±6.80)分,精神健康生活质量(MCS)得分为(50.10±9.22)分。PCS中生理功能(PF)、躯体疼痛(BP)和一般健康状况(GH)维度得分均显著低于四川省常模(均P0.05),而生理职能(RP)维度得分与四川省常模比较差异无统计学意义(P=0.581)。MCS中精力(VT)、社会功能(SF)、情感职能(RE)维度得分与四川省常模比较差异均无统计学意义(均P0.05),而精神健康(MH)维度得分显著高于四川省常模(P0.01)。肝移植受者的生活质量得分与面对和回避应对方式均无相关性,与屈服应对方式呈显著负相关(r=-0.310~-0.542,P0.05或P0.01)。结论肝移植术后精神方面各维度得分显著优于生理方面各维度得分。屈服应对方式对肝移植受者生活质量有负性影响。     

儿童活体肝移植中供者的生命质量和心理健康评估

目的 探讨儿童活体肝移植中供者的术后生命质量和心理健康水平.方法 回顾性分析2006年10月至2012年12月上海交通大学医学院附属仁济医院收治的45例儿童活体肝移植中供者的临床资料.采用SF-36生命质量调查表和SCL-90症状自评量表,评估45例供者术后生命质量和心理健康情况.术后采用门诊复查方式进行随访,随访时间截止2013年5月.采用t检验或秩和检验分析供者性别、年龄、身高、体质量、体质指数、户口类型、医疗保险类型、供者手术时间、术中出血量和随访时间等因素对供者术后生命质量和心理健康的影响.结果 45例供者均施行了肝左外叶切除术,其手术时间为(302±103)min、术中出血量为(187±40)ml,供者术中均未输血.45例供者术后无手术相关并发症和死亡发生,全部康复出院,平均住院时间为(7±2)d.45例供者术后获得随访,中位随访时间为636 d(163 ～2413 d).供者术后行SF-36生命质量调查量表评估:其健康改变、一般健康、生理功能、生理职能、情感职能、社会功能、躯体疼痛、活力和精神健康9个方面得分分别为:(61±25)分、(55±17)分、(89±14)分、(80±26)分、(87±25)分、(66±20)分、(82±18)分、(63±14)分、(63±15)分.SCL-90症状自评量表评估:其躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执和精神病性9个方面中位得分分别为:0.25分(0～1.58分)、0.20分(0～1.60分)、0.11分(0～0.89分)、0.15分(0～1.62分)、0.10分(0～ 1.00分)、0.17分(0 ～2.67分)、0分(0～1.00分)、0分(0～1.33分)和0分(0～0.80分);其中2名供者在敌对症状上得分均为2.67分,怀疑存在敌对症状,其余供者在以上9个方面得分均＜2.5分.进一步分析影响供者术后生命质量和心理健康的因素,其结果显示:随访时间＜636 d的供者其一般健康状况要优于随访时间≥636 d的供者(t =-2.448,P＜0.05);年龄＜34岁的供者比年龄≥34岁的供者具有更好的社会功能和精力(t=-2.180,-2.267,P＜0.05),且躯体化和恐怖症状更少(Z=3.106,2.537,P＜0.05).结论 儿童活体肝移植中供者术后生命质量、心理健康评估满意,供者的年龄和随访时间影响其术后生命质量和心理健康水平,这将为儿童活体肝移植供者的选择提供一定参考.     

呼吸训练对鼻腔填塞患者耐受性的影响

目的探讨婚姻支持对糖尿病视网膜病变（DR）患者心理和生活质量的影响。方法采用中文版低视力者生活质量量表（CLVQOL）、Olson婚姻质量调查问卷和症状自评量表（SCL-90）对218例DR患者的生活质量、婚姻质量及心理状况进行调查,并进行相关性分析。结果无配偶组（45例）、婚姻质量低组（91例）CLVQOL中大多数维度评分和总分显著低于婚姻质量高组（82例;P〈0.05,P〈0.01）。无配偶组、婚姻质量低组的躯体化、强迫、人际关系、抑郁、焦虑、偏执、精神病性等因子评分及SCL-90总分显著高于婚姻质量高者（P〈0.05,P〈0.01）。有配偶患者婚姻质量中婚姻满意度、性格相容性、夫妻交流、解决冲突方式、经济安排、性生活、与亲友关系、角色平等因子分,Olson总分与CLVQOL总体分呈显著正相关（P〈0.05,P〈0.01）,与SCL-90总分呈显著负相关（P〈0.05,P〈0.01）。结论婚姻支持有利于维持、改善DR患者生活质量和心理状况,护理人员应引导患者及配偶增强主动寻求、合理利用、适时改善婚姻支持的意识。     

美容整形受术者术前生活质量及其与术后满意度的相关研究

目的：探讨美容整形受术者的术前生活质量及其与术后满意度的相关性。方法：选用＂生活质量综合评定问卷（GQOLI-74）＂对美容整形受术者进行术前生活质量调查,术后2个月随访受术者术后满意度,用SPSS16.0进行统计分析。结果：生活质量调查结果为：躯体功能维度（63.93±8.44）、心理功能维度（70.61±10.60）、社会功能维度（70.27±10.89）、物质生活维度（67.82±13.88）、生活质量总评（14.06±2.53）、总评分（297.31±24.83）;术后满意度方面,有16.2%的受术者术后非常满意,64.9%比较满意,18.9%不太满意,无非常不满意。术后满意度与生活质量综合评定问卷的第F26、46、57、69、72条目存在相关关系。结论：美容整形受术者术前生活质量较高,其与术后满意度有相关性。     

农村慢性病高危人群健康素养与健康结局的关系研究

目的了解农村慢性病高危人群健康现状,探讨农村慢性病高危人群健康素养和健康结局的关系。方法采用随机抽样和便利抽样法,从广州中医药大学护理学院的19个三下乡服务点抽取5个服务村的慢性病高危人群,采用慢性病患者健康素养量表、一般自我效能量表、生活质量量表调查慢性病高危人群的人口学资料、健康素养和健康结局,并构建结构方程模型。结果农村慢性病高危人群健康素养总分为93.5±15.4,具备率为52.2%;自我效能低于全国常模(P0.01);除生理职能维度外,生活质量的其他7个维度得分低于全国普通人群(均P0.01);与全国慢性病患者群组比较,生理功能、生理职能、总体健康和活力4个维度得分较高,躯体疼痛、精神健康2个维度得分较低(P0.05,P0.01);结构方程模型显示,农村慢性病高危人群健康素养水平越高,自我效能感越高,生活质量水平越高(P0.01);自我效能在健康素养和生活质量间具有中介作用(P0.05)。结论农村慢性病高危人群健康素养水平、自我效能、生活质量不尽人意;提高健康素养有助于改善该类人群的健康结局。     

供体年龄对活体肾移植预后的影响

目的 探讨供体年龄对活体肾移植预后的影响.方法 回顾性分析2004年至2011年间在我院实施的活体亲属肾移植217例,按供体年龄或供受体年龄差异分组,随访并比较各组受者的血肌酐水平和术后并发症情况.结果 随着供体年龄的增长,受体移植术后血肌酐水平呈上升趋势.与供受体年龄差＜-5岁组比较,供体年龄差＞5岁组的Scr水平在1个月[(143.5±42.1) μmol/L比(114.4±30.4)μ mol/L]、3个月[(139.9±36.6) μmol/L比(110.6 ±33.3)μmol/L]、1年[(132.1±22.1)μmol/L比(105.5±35.9) μmol/L]及2年(132.0±45.4) μmol/L比(97.2±17.5) μmol/L]均增高,差异有统计学意义(均P＜0.05).与年轻供肾组(＜50岁)相比,老年供肾组(＞50岁)的急性排斥反应发生率(19.4％比9.7％)和慢性排斥反应发生率(9.7％比1.4％)也显著增高(均P＜ 0.05).术后人及肾的存活率比较差异无统计学意义.供受体年龄差异是术后2年Scr水平异常的独立危险因素(OR=5.010,P＜0.05).结论 供体年龄是肾移植预后的重要影响因素,老年供肾的疗效较差.     

亲属活体供肾移植52例随访

目的 调查分析亲属活体供肾移植供、受者术后的肾功能及生活质量情况.方法 以行亲属活体供肾移植的供受者52对、接受尸体肾移植的受者56例以及随机抽取的同期健康人60名为研究对象.于移植术前、术后3个月和1年对研究对象进行调查,采用调查问卷和临床检验相结合的方式.调查内容包括年龄、性别、婚姻状况、供受者的关系等以及健康状况调查问卷SF-36量表.结果 供者术后3个月及1年的血Cr和24 h尿蛋白均高于术前,但未超过正常范围.供者术前、术后3个月及1年的血Cr、GFR和24 h尿蛋白与健康人相比,差异均无统计学意义(P>0.05).活体供肾移植受者术后3个月及1年的血Cr与BUN均低于相应时间点的尸体肾移植受者,差异有统计学意义(P<0.05).供者术后3个月及1年的生活质量与术前相比,差异均无统计学意义(P>0.05);供者术前、术后3个月及1年的生活质量与健康人相比,差异均无统计学意义(P>0.05).活体供肾移植受者术后3个月及1年的生活质量与相应时间点的尸体肾移植受者相比,差异均无统计学意义(P>0.05).结论 活体供肾移植供者在切除肾脏后肾功能未见减退,生活质量与健康人群相比无明显差异;受者术后的移植肾功能恢复明显优于尸体肾移植受者.     

Intraoperative blood loss is a risk factor for complications in donors after living donor hepatectomy.

Complications in a donor are a distressing but inevitable occurrence, since graft procurement is a major undertaking. Although the technique for procurement has some similarities to hepatic resection, a donor is very unlike a patient with malignancy. The risk factors identified in these patients cannot be extrapolated to donors. Donor hepatectomy carried out from June 1995 to March 2005 in Chang Gung Memorial Hospital, Kaohsiung Medical Center was reviewed with the aim of identifying risk factors for complications. There were 204 living donor liver transplants, with 205 donor hepatectomies, as 1 living donor liver transplantation was a dual graft. Ten donors (4.88%) suffered complications. There was no difference in terms of age, gender, body weight, operation, and parenchymal time between those who had complications and those who did not. There was also no difference in liver function tests between the 2 groups of donors, but the total bilirubin was significantly higher in donors with complications. The graft weight and remnant liver volume were also similar. The proportion of donors with fatty liver was the same between the 2 groups. The mean blood loss in donors with complications was 170 +/- 79 mL, and that for donors without complications was 95 +/- 77 mL. There was a statistically significant greater blood loss in donors with complications (P < 0.05). The number of segments removed in donors with complications was also higher compared to donors without complications (P < 0.03). Using multivariate analysis, intraoperative blood loss and the number of segments removed were found to be independent risk factors for donor complications. Intraoperative blood loss during graft procurement must be kept low to minimize complications in donors.     

99mTc-DTPA肾动态显像在评价活体供肾者肾小球滤过率中的应用

目的 探讨99mTc-DTPA肾动态显像在评价活体肾移植供者肾小球滤过率(GFR)中的应用,并观察GFR水平与供者年龄和性别的相关性.方法 212名候选供者均接受肝肾超声波、肝炎病毒感染以及与受者的血型和组织配型等全面检查,如上述检查符合供肾的一般要求,则进一步行99mTc-DTPA肾动态显像检测候选供者的GFR,如GFR≥1.33 ml/s(1 ml/s=60 ml/min),则认为GFR正常;如1.17 ml/s≤GFR＜1.33 ml/s,则行内生肌酐清除率(CCr)检查,如CCr正常,则认为GFR正常,如CCr异常,则候选供者放弃供肾;如GFR＜1.17 ml/s,则候选供者放弃供肾.供者选取后,应用等级相关系数分析不同性别和不同年龄供者间的GFR水平的差异.结果 212名候选供者中,GFR≥1.33 ml/s者137名;1.17 ml/s≤GFR＜1.33 ml/s者55名,其中31名因CCr异常或其他安全性考虑而放弃供肾;GFR＜1.17 ml/s者20名.共有161名候选供者最终被选择为供者供肾,其中男性105名,女性56名,年龄(42.91±11.90)岁(20～62岁).供肾前,男性和女性供者双肾总的GFR分别为(1.51±0.22)ml/s和(1.45±0.18)ml/s,二者间差异无统计学意义(P＞0.05);不同年龄各组间GFR水平的差异均无统计学意义(P＞0.05),老年(＞55岁)和中青年(≤55岁)供者间GFR水平分别为(1.48±0.22)ml/s和(1.49±0.17)ml/s,二者间差异无统计学意义(P＞0.05).相关性分析显示,供者GFR与其年龄无明显相关性(r=-0.033,P=0.69),男性和女性供者的GFR水平与其年龄也无明显相关性(r=-0.053,P=0.571;r=-0.019,P=0.754).供肾后,所有供者短期内肾功能均恢复至正常水平,未发生肾功能异常和严重并发症.结论 99mTc-DTPA肾动态显像在评价活体肾移植供者GFR中具有较好准确性和可重复性;1.33 ml/s＞GFR≥1.17 ml/s者经严格筛选后可作为供者供肾,且预后良好;供者GFR水平与其年龄和性别间无明显相关性.     

Quality of life of living kidney donors in Brazil: an evaluation by the short form-36 and the WHOQOL-bref questionnaires

Abstract: Introduction: There are few studies that evaluate donors’ quality of life (QOL) following renal transplant in developing countries. This study was conducted to evaluate post‐donation QOL of Brazilian living kidney donors using SF‐36 and WHOQOL‐bref questionnaires. Subjects and methods: Demographic, socioeconomic and the QOL data were analyzed utilizing SF‐36 and WHOQOL‐bref questionnaires of 69 living kidney donors and compared with 68 non‐donor subjects from the same community. Results: The donors and controls were similar as for gender and ethnicity, predominating the female. There was no difference in the educational level or socioeconomic class between the groups, the lower income being more prevalent. The evaluation of the donors’ QOL was not significantly different from that of the control group. In some domains of the SF‐36 and of the WHOQOL‐bref questionnaires, donors scored higher than controls. Even the evaluation of the QOL of donors whose recipients had suffered loss of the graft or death following renal transplantation, showed in a general manner a similar QOL to the controls. Conclusions: Living kidney donors in a mainly low‐income segment of the Brazilian population present a post‐donation quality of life equal or superior to that of the non‐donor population with the same socioeconomic profile. The two generic instruments used to evaluate the quality of life presented similar results.     

Influence of donor histology on outcome in patients undergoing transplantation for hepatitis C

BACKGROUND: Risk factors for graft loss and recipient death in liver transplantation for hepatitis C virus (HCV) have been extensively investigated. Donor age was defined as one of the most important predictors of outcome in these patients; however, the mechanism leading to more severe recurrent hepatitis has not yet been investigated. METHOD: In a retrospective analysis, histological findings of 79 donor liver grafts were assessed according to criteria inflammation, fibrosis, fatty degeneration, and necrosis. These findings were correlated with the histological and clinical course of HCV-positive liver graft recipients. RESULTS: The overall 1-, 5- and 10-year graft survival figures were 85%, 77%, and 60%, respectively. We could not identify any correlation between outcome, fat content, and necrosis in the donor liver. However, stage 3 and 4 fibrosis 1 year after liver transplantation was significantly increased in the group of patients receiving a graft from a donor with portal inflammation (P<0.05). Additionally, the occurrence of intrahepatic inflammation was significantly increased in older donors (P<0.05) and donors with prolonged intensive care hospitalization (P<0.05). CONCLUSION: A number of risk factors for detrimental outcome in HCV-positive patients after liver transplantation have been identified. In particular, older donor age significantly impaired outcome in recent analysis, but due to donor shortage it is not possible to provide young grafts for all HCV-positive patients. Our data show that donor histology is helpful in identifying patients with more severe recurrent hepatitis prior to transplantation, and that especially in older donors, prolonged intensive care hospitalization should be avoided.     

大泡性脂肪变性对活体肝移植右半肝供者早期预后的影响

目的 研究轻度大泡性脂肪变性对活体肝移植供者右半肝切除术后早期肝功能恢复及再生的影响.方法 回顾性分析2007年10月至2009年5月间本移植外科小组完成的95例活体肝移植术(living donorlivertransplantation LDLT)供者的临床资料.术中冰冻活检发现15例存在轻度大泡性脂肪变性(20%～30%5例,10%～19%10例)(A组),80例无明显脂肪变性(B组).比较两组术前基本资料及术后临床结果.结果 单因素分析发现A、B两组术前平均年龄、性别比、残肝体积比、保留肝中静脉/不保留肝中静脉比无显著差异(P=0.870,P=0.608,P=0.928,P=0.196),但A组体重指数(BMI)显著高于B组(P=0.013).t检验发现A组术后总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)峰值显著高于B组(P=0.001,P=0.039),2组术后半月的肝脏再生率无显著差异(P=0.939);Logistic多因素统计分析发现轻度大泡性脂肪变性是导致供者术后高胆红素血症的危险因素(OR=5.375,95%可信区间1.467-19.696,P=0.011).结论 轻度大泡性脂肪变性是术后高胆红素血症的独立危险因素,从供者安全性考虑,对活体肝移植供者需仔细进行术前评估.     

The impact of donor age on living donor liver transplantation

BACKGROUND: The impact of the age of the donor on the outcome of living related liver transplantation is yet to be clarified. METHODS: During October 14, 1996 and December 20, 1999, 34 living related liver transplantations were performed. Of these, 26 cases were performed using the extended left lobe graft, which were classified into three groups; younger donor group (group Y, donor age < 30, n = 7), middle-aged donor group (group M, 30 < or = donor age <50, n=13), and older donor group (group O, donor age < 50, n = 6). Early allograft function and regeneration were compared between these groups. RESULTS: There was no difference in standard liver volume, and predicted or harvested graft size between the three groups. Although serum transaminase and total bilirubin levels within postoperative day 7 were not different between the groups, the prothrombin time on postoperative day 3 was significantly longer in group O than in group Y. One week after transplantation, group Y had significantly greater graft/standard liver volume ratio than group O, and greater graft volume than group M and O. One month after transplantation, however, there was no significant difference in such graft size parameters between the groups. Graft and patient survival were comparable between the three groups. CONCLUSION: Although function and regeneration of the allografts from older donors in living donor liver transplantation is worse than those of their younger counterparts, the outcome is not affected by the age of the liver.     

A Comparison of Surgical Outcomes and Quality of Life Surveys in Right Lobe vs. Left Lateral Segment Liver Donors

Concern remains regarding the possibly higher risk to living liver donors of the right lobe (RL), as compared with the left lateral segment (LLS). We studied outcomes and responses to quality of life (QOL) surveys in the two groups.
From 1997 to 2004, we performed 49 living donor liver transplants (LDLTs): 33 RL and 16 LLS. Notable differences included a higher proportion of female and unrelated donors in the RL group. A significantly larger liver mass was resected in RL (vs. LLS) donors: 720 (vs. 310) g, p = 0.01; RL donors also had greater blood loss (398 vs. 240 mL, p = 0.04) and operative times (7.2 vs. 5.7 h, p = 0.05). However, those findings did not translate into significant differences in donor morbidity. The complication rate was 12.5% in LLS donors and 9.1% in RL donors (p = ns). Per a QOL survey at 6 months postdonation, no significant differences were noted in SF-12 scores for the two groups. Recovery times were somewhat longer for RL donors. Mean time off work was 61.0 days for RL donors and 32.4 days for LLS donors (p = 0.004).
RL donation is associated with greater operative stress for donors, but not necessarily with a more complicated recovery or differences in QOL.     

Kombinierte Nieren-Pankreas-Transplantation

BACKGROUND: Differences in graft survival due to gender have been reported after transplantation of the kidney, liver, and heart. However, little is known about the role of donor and recipient gender in simultaneous pancreas-kidney transplantation. METHODS: Single-centre analysis was performed of first simultaneous pancreas-kidney transplantations performed between 1994 and 2005 at the Bochum Transplant Center in Germany (n=218). RESULTS: Recipients of female donor organs exhibited acute organ rejections earlier and more frequently (P<0.05). Male recipients of organs from male donors had a lower risk of acute rejection than recipients of female donor organs (P<0.05). In addition to female donor gender, higher donor age and early kidney dysfunction were risk factors for perioperative rejection (P<0.05). Long-term kidney and pancreas function was best in male-donor-to-female-recipient transplants over the time periods of 7 and 3 years, respectively (P<0.05). Risk factors of long-term organ failure were: the need of revision laparotomy, organ rejection, and early postoperative organ dysfunction (P<0.05). CONCLUSION: This is the first report of graft function after simultaneous pancreas-kidney transplantation looking specifically at gender differences with respect to donor and recipient. There was an increased risk of organ rejection of female donor organs.