International journal of surgery (London, England) · 2018
Outcomes of renal transplant from donors with polycystic kidney disease.
Клинический случайСтатьяОбзорНазвание и аннотация: Перевод в очереди
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Shamali Awad, Milsom-Mcquillan Sarah, Gibbs Paul
Аннотация
INTRODUCTION: Kidneys from donors affected by autosomal-dominant polycystic kidney disease (ADPKD) are, in general, considered unsuitable for transplantation. However, some authors report cases of patients who received kidneys from a deceased ADPKD donor showing encouraging outcomes. Our aim is to provide our experience of a patient with end stage renal failure who received a deceased donor kidney from a 29-year-old who themselves had been diagnosed with ADPKD but well maintained renal function, and to provide a comprehensive review of all the published literature.
METHODS: In addition to our case, a literature search (PubMed database, Embase, Cochrane Library) of articles published between 1980 and 2017 was performed.
RESULTS: Sixteen cases were identified. Median donor age was 24 (range12-55) years old. Median recipient age was 46 (range 19-72) years old. Fifteen cases had a single kidney transplant and one case had a dual kidney transplant. 13/16 (81%) had immediate function, 2 patients (12.5%) had delayed graft function and one patient (6.25%) had primary non-function. Median graft follow up was 36 months (range 6-180). Median serum creatinine at last follow up was 124 μmol/L (range75-442). Thirteen patients (81%) were still alive with a working renal transplant at last follow up.
CONCLUSION: The published literature is encouraging and supports the use of polycystic kidneys from younger deceased donors. Therefore, we believe that if kidneys from ADPKD donors are offered, they should have a full assessment and be considered acceptable for renal donation to recipients who may have a life expectancy of 10 years or less and who are fully informed and have the capacity to consent to receiving a polycystic kidney.
METHODS: In addition to our case, a literature search (PubMed database, Embase, Cochrane Library) of articles published between 1980 and 2017 was performed.
RESULTS: Sixteen cases were identified. Median donor age was 24 (range12-55) years old. Median recipient age was 46 (range 19-72) years old. Fifteen cases had a single kidney transplant and one case had a dual kidney transplant. 13/16 (81%) had immediate function, 2 patients (12.5%) had delayed graft function and one patient (6.25%) had primary non-function. Median graft follow up was 36 months (range 6-180). Median serum creatinine at last follow up was 124 μmol/L (range75-442). Thirteen patients (81%) were still alive with a working renal transplant at last follow up.
CONCLUSION: The published literature is encouraging and supports the use of polycystic kidneys from younger deceased donors. Therefore, we believe that if kidneys from ADPKD donors are offered, they should have a full assessment and be considered acceptable for renal donation to recipients who may have a life expectancy of 10 years or less and who are fully informed and have the capacity to consent to receiving a polycystic kidney.