Clinical study of techniques for cadaveric donor nephrectomy (report of 1439 cases) / 中华泌尿外科杂志

ABSTRACT

Objective To explore the best procurement technology for cadaveric donor nephrectomy. Methods Clinical data of 1 439 donors nephrectomy in the past 24 years were retrospected.Bilateral nephrectomy,en bloc removal of both kidneys and en bloc removal with in situ cooling both kidneys were adopted in different periods of time.Operation time(OT),hot ischemia time(HIT),cold ischemia time(CIT),total ischemia time(TIT), renal graft beginning to produce urine time after revascularization(UT),renal function recovery time(RRT), damage rate(DR),quantity of preservation solution(PS), rate of acute tubular necrosis(ATN),primary non function(PNF) and poor perfusion of donor kidney(PPK) were observed and comparad among the 3 techniques. Results 216 cases were accomplished by bilateral nephrectomy and 432 kidneys were procured.1 134 cases were accomplished by en bloc removal and 2 264 kidneys were procured(4 cases had only one kidney each).Eighty nine cases were accomplished by en bloc removal with in situ cooling and 178 kidneys were procured. HIT of these three techniques (bilateral nephrectomy,en bloc removal and en bloc removal with in situ cooling) were 8.22?3.01min?5.35?1.88min?1.89?0.92min ( P 0.05).UT were ( 28.24 ?10.65)min,(22.72?8.35)min,(9.26? 10.95 )min.RRT were (9.98?6.84)d,( 7.59 ?6.35)d,(4.91? 7.68 )d.ATN were 15.40%,7.31%,3.98%( P