供肾合并囊肿的亲属肾移植

目的:了解供肾合并囊肿对亲属肾移植疗效的影响。方法:回顾分析2005年11月—2011年6月28例供肾合并囊肿的亲属肾移植临床资料。结果:供者男性12例,女性16例,年龄44～64岁,平均年龄52.5岁,其中≥60岁6例;受者男性21例,女性7例,年龄20～44岁,平均年龄26.4岁。肾移植受者分别在术后7 d、1个月、6个月、12个月复查血肌酐;门诊彩超检查随访受者囊肿变化。术前彩超及CT检查发现供肾单纯性肾囊肿27例,肾盂旁囊肿1例;单纯性肾囊肿按囊肿位置又分为周围型肾囊肿20例,中心型肾囊肿7例;囊肿直径4～40 mm,平均直径23 mm。供者28例均采用开放术式取肾,所有供者均未发生手术相关并发症。肾移植手术中,开放血管后对20例周围型肾囊肿及1例肾盂旁囊肿行囊肿去顶减压,对7例中心型肾囊肿术中未处理。28例受者均获随访,平均随访时间为19个月。术后7 d、1个月、6个月、12个月血肌酐分别为(148±42)μmol/L、(118±54)μmol/L、(105±39)μmol/L和(110±45)μmol/L;彩超检查随访发现囊肿去顶减压后均未复发,7例中心型肾囊肿随访未见囊肿增大。结论:供肾合并囊肿不应作为供者禁忌。

Donating Kidney with Cysts on the Prognosis of Living-Related Recipients

To analyze whether donating kidney with cysts can influence the prognosis of living-related kidney trans- plantation. Methods： The clinical data of 28 cases of living-related kidney transplantation with cysts from November 2005 to June 2011 in our hospital were retrospectively analysed. Results： There were 12 male and 16 female donors （age ranged from 44 to 64 years, mean age 52.5 years）, 6 donors are over 60 years; 21 male and 7 female recipients （age ranged from 20 to 44 years, mean age 26.4 years）. We analyzed the serum creatinine levels of them on the 7th day and 1st, 6th, 12th month after surgery. Ultrasound and CT scans revealed 27 cases of simple renal cyst and 1 case of parapelvic cyst. A total of 20 cases of cysts presenting on the surface of the kidney and 7 cases of intraparenchymal cysts were found. The diameter ranged from 4 mm to 40 mm （mean diameter 23 mm）. All 28 kidneys were harvested by open surgery. All donors did not have complications re- lated to the surgery. A total of 20 cases of cysts presenting on the surface of the kidney and 1 case of parapelvic cyst were re- sected. Decortication or resection of intraparenchymal cysts were not performed. All of the 28 recipients were carefully fol- lowed-up. The serum creatinine levels were 148 ± 42/μmol/L, 118 ± 54 μmol/L, 105 ± 39 μmol/L and 110 ±45 μmol/L on the 7th day and 1st, 6th, 12th month after surgery. The recurrence of renal cysts after renal cystectomy and the augment of diame- ter intraparenchymal cysts were not found during the follow-up with ultrasound. Conclusions： Renal cyst should not be consid- ered as barriers to organ donation.