Abstract:

BACKGROUND: Living donor kidney transplantation has relationship with both lives of donors and recipients. It is required that operation for donor and recipient should be ensured to be successful. Because of large operation risk and high technical requirements, it is critical to choose the cutting method of donor kidney, in order to ensure the donor’s safety.
OBJECTIVE: To summarize the clinical experiences about 37 cases of the 12th-rib supracostal incision through back and waist in relative living donor kidney cutting technique, and to evaluate its effect and reliability.
METHODS: Totally 40 operations of relative living donor kidney transplantation have been completed at the Department of urinary surgery, RuiKang Hospital Affiliated to Guangxi Chinese Traditional Medicine College, from June 2007 to August 2008. Among the 40 operations, there were 37 operations adopting the 12th-rib supracostal incision technique to cut and take relative living donor kidney. The relevant clinical data of the donors and the recipients were reviewed and analyzed. Meantime, 40 cases received cadaveric renal transplantation at corresponding time periods were selected as controls. The differences of recovery times of serum creatinine, occurrence rates of acute rejection, delayed graft function, related complication were compared.
RESULTS AND CONCLUSION: The operation was successful in all 37 cases. The operating times of all donors were 1.0-2.0 hours, the warm ischemic time of donor kidney was about 15 seconds, and the cold ischemic times were 1.0-2.0 hours. No much haemorrhage occurred during the process of operation. No surgical complication and medical complication occurred during the peri-operation period. The kidney function of recipient recovered rapidly after operation. All of the creatinine levels could be restored to normal in 1 week. Up till now, all donors and recipients survived. Moreover, the functions of transplanted kidney were in normal range. Compared with the 40 cases with cadaveric kidney transplantation in the same period, the donors of living-relative donor kidney transplantation have more advantages in the following aspects: shorter recover time for creatinine, lower occurrence rates of acute rejection and delayed graft function after transplantation. The opening cutting and taking donor kidney operation of the 12th-rib supracostal incision through back and waist not only has the advantages of short operation time and short warm ischemic time, but also has the advantage of reliability. Together with high survival rate of patient and kidney, the quality of the relative living donor kidney transplantation is also satisfied.