The outcomes of donor nephrectomy in our department

Ali ÇİFT, İsmet YAVAŞÇAOĞLU, Bülent OKTAY, Hakan VURUŞKAN, Ümit ŞİMŞEK

Abstract

The use of renal allograft from living related donors beside cadaveric donors is an ideal form of renal replacement therapy for end stage renal disease. 118 patients were underwent renal transplantation from 77 living relat-ed and 41 cadaveric donors between 1989 and 2001. Nephrectomy was performed under general anaesthesia using flank, extraperitoneal approach with a rib resection if needed. Left donor nephrectomy was carried out in 53 patients and right donor nephrectomy was carried out in 24 patients. None of the donors required blood transfusion during or after the operation. There was no wound infection, pneumonia and deep vein thrombosis. The creatinin clerance was 78.0+3.5 mllmin (range 32 to 106 mllmin) soon after the operation (on the 4th postoperative day). Length of stay aver-aged 5+1.4 days. Average follow up of donors was 61 ±8 months (2-150 months) and none of the donors had deterio-ration in renal functions and status of blood pressure. After appropriate preoperative donor evaluation and under ade-quate operation conditions long term donor outcomes demonstrate that living related donor nephrectomy is a safe pro-cedure with an acceptable morbidity and mortality.

Özet

Organ kaynagi olarak kadavra donorlerin yamnda canli akraba donorlerin kullanilmasi son doneni bobrek yet-mezliginin tedavisinde kabul edilmis bir yontemdir. Klinigimizde 1989-2001 yillan arasinda 77'si canli 41'i kadavra dondrden toplam 118 olguya renal transplantasyon uygulandi. Donor nefrektomisi; genel anestezi altinda, flank ekstraperitoneal yaklagimla, gerektigbyie kot rezeksiyonu yapilarak uygulandi. Donorlerin 53'une sol, 24'une sag nefrektomi yapildi. Operasyon sirasinda veya sonrasmda higbir olguda kan transfiizyonu gerekmedi. Higbir hastada yara enfeksiyonu, akciger enfeksiyonu veya derin ven trombusii geli§medi. Operasyon sonrasi erken donemde (postop-eratif 4. gun) kreatinin klirensi 78.0+3.5 mlldk (32-106 mlldk arasinda) olarak saptandi. Operasyon sonrasi ortalama hastanede kalis surest 5.0+1.4 giindii. Donorlerin ortalama takip sureleri 61 ±8 aydi (2-150 ay). Bu sike iginde takip edilen donorlerin higbirisinde bobrek fonksiyonlannda bozulma veya hipertansiyon geli§imi saptanmadi. Medikal olarak uygun hastalann secimi titizlikle yapildiginda ve operasyon yeterli ameliyathane sdrtlarinda gergeklestirildiginde, bu hastalann uzun doneni analizleri canli donor nefrektomisinin, hasta igin kabul edilebilir mor-bidite ve mortalite igeren, giivenilir bir girisim oldugunu gostermektedir.