Living-related Donor Kidney Transplantation: A Clinical Report Of 60

Objective TO introduce the clinical experience on living related donor kidney transplantation(LRKT).Methods A retrospective analysis of 60 recipients receiving LRKT was performed. Expect for 3 cases being donated by spouse, the remaining cases were donated by blood relationship donors. Potential living donors underwent fully medical evaluation before operation. Donors and recipients of ABO blood type and RH blood group are in line with the principles of blood transfusion, and all of the complement-dependent lymphocytoxicity are negative. Expect for 29 cases underwent laparoscopic nephrectomy, the others underwent open nephrectomy, in which 4 cases donated right kidneys and 56 cases donated left kidneys. Tripe-combined immunosuppressive protocols consisted of calcineurin inhibitors (CNI),MMF and steroid.Results The average hospital stay of donors was (7.1±1.5) days. Mean creatinine concentration was higher at 1 st day,7 days,lmonth,3 months after nephrectomy than preoperatively(P<0.05).However,apart from the 1 st day after a small number of donor serum creatinine higher than normal ,the other still in the normal range. The mean warm/cold ischemia time of grafts was (2.3±1.3) / (172.5±52.7) min respectively. Because the laparoscopic living donor nephrectomy is about 48%,the mean warm ischemia time of grafts was longer than normal. One for two cases of renal ischemia secondary. One case of donor has lymphatic leakage after nephrectomy .The longest follow-up time of recipient was up to 48 months. The actuarial patient and graft survival rates at 3 years were 90%, Acute rejection(AR) episodes occurred in 4 patients. Delayed recovery of renal function occurred in 3 patients.Conclusion LRKT is safe. Edge donor need more stringent screen. Laparoscopic nephrectomy with light wounds,less pain,less bleeding,less postoperative analgesic drug use,shorter hospital stay,quick recovery, the advantages of a small scar. LRKT is proved to have good long-term outcome due to short ischemic time, less rejection, better tissue typing and lower dose of immunosuppressive agent. Strictly evaluating the procedure before operation is one of the keys to protect donors and recipients.