RESUMEN
INTRODUCTION: Renal transplantation (RT) is currently the treatment of choice in end-stage renal disease. The Gregorio Marañón hospital performed 65 RT, 97.01 pmp, this year. OBJECTIVE: To study the characteristics which RT patients from non-heart beating donors have in the immediate post-transplantation renogram. To know the evolution of the renal function, by renogram. METHODS: Ten patients with NHBD graft out of 65 patients with RT were studied in the year 2003. RESULTS: The study is made up of 10 patients with RT from NHBD, with an average timing of warm ischemia of 35 min and average timing of cool ischemia 21 h. In the post-transplantation renal function study, 9 of then showed hemodilution and one an acute tubular necrosis (ATN) pattern. In most of the cases, the study was performed the day after the RT except for one that was performed on the 4th day (1.7 +/- 1 days). Renal perfusion was conserved in every case. The renal graft maintained this type of record until post-RT day 7 (6.67 +/- 0.57 days) and evolved towards ATN after day 10 (11.65 +/- 1.5 days) and normal range on day 55 +/- 51.1 post-transplantation. All patients supported the graft, with acceptable renal function, except one of then who was treated with transplantectomy due to a renal venous thrombosis. CONCLUSION: The renal function study showed "hemodilution" in the first post-transplantation in 90 % of the RT from NHBD. Evolution went from ATN to normality. The NHBD are adequate for transplantation, significantly shortening the waiting time for RN.
Asunto(s)
Trasplante de Riñón , Adulto , Cadáver , Femenino , Humanos , Masculino , Persona de Mediana Edad , Renografía por Radioisótopo , Donantes de TejidosRESUMEN
Introducción: El trasplante renal (TR) es actualmente el tratamiento de elección en la enfermedad renal terminal. El HGU Gregorio Marañon realizó 65 TR. Objetivo: Estudiar las características que presentan los pacientes con TR de donante de cadáver en asistolia (NHBD) en el renograma post-trasplante inmediato. Conocer la evolución de la función renal, mediante renograma. Material: De 65 pacientes con TR en el año 2003, se estudian 10 con injerto NHBD. Resultados: 10 pacientes con TR de NHBD, con edad 44 ± 10 años (29-62 años), 6 mujeres, tiempo de isquemia caliente 35min y tiempo de isquemia fría 21 h. Nueve de ellos mostraron en el estudio de función renal post-transplante, curva dilución sanguínea y uno un patrón de NTA. El estudio fue realizado en la mayoría de los casos al día siguiente del TR excepto uno que se efectuó el 4.º día (1,7 ± 1 días) En todos los casos la perfusión renal estaba conservada. El injerto renal mantuvo este tipo de registro hasta el día 7.º post. TR (6,67 ± 0,57 días). Evolucionando, hacia NTA a partir del 10 día (11,65 ± 1,5 días) y a la normalidad el día 55 ± 51,1 post-transplante. Todos los pacientes mantienen el injerto, excepto uno de ellos, que hubo que realizar trasplantectomía a causa de trombosis de la vena renal. Conclusión: El 90 % de los TR procedentes de NHBD muestran en los primeros días post-trasplante un estudio de función renal de "dilución sanguínea". La evolución es a NTA y a la normalidad. Los NHBD son aptos para transplante, disminuyendo de forma significativa el tiempo de espera para TR
Introduction: Renal transplantation (RT) is currently the treatment of choice in end-stage renal disease. The Gregorio Marañón hospital performed 65 RT, 97.01 pmp, this year. Objective: To study the characteristics which RT patients from non-heart beating donors have in the immediate post-transplantation renogram. To know the evolution of the renal function, by renogram. Methods: Ten patients with NHBD graft out of 65 patients with RT were studied in the year 2003. Results: The study is made up of 10 patients with RT from NHBD, with an average timing of warm ischemia of 35 min and average timing of cool ischemia 21 h. In the post-transplantation renal function study, 9 of then showed hemodilution and one an acute tubular necrosis (ATN) pattern. In most of the cases, the study was performed the day after the RT except for one that was performed on the 4th day (1.7 ± 1 days). Renal perfusion was conserved in every case. The renal graft maintained this type of record until post-RT day 7 (6.67 ± 0.57 days) and evolved towards ATN after day 10 (11.65 ± 1.5 days) and normal range on day 55 ± 51.1 post-transplantation. All patients supported the graft, with acceptable renal function, except one of then who was treated with transplantectomy due to a renal venous thrombosis. Conclusion: The renal function study showed "hemodilution" in the first post-transplantation in 90 % of the RT from NHBD. Evolution went from ATN to normality. The NHBD are adequate for transplantation, significantly shortening the waiting time for RNIntroduction: Renal transplantation (RT) is currently the treatment of choice in end-stage renal disease. The Gregorio Marañón hospital performed 65 RT, 97.01 pmp, this year. Objective: To study the characteristics which RT patients from non-heart beating donors have in the immediate post-transplantation renogram. To know the evolution of the renal function, by renogram. Methods: Ten patients with NHBD graft out of 65 patients with RT were studied in the year 2003. Results: The study is made up of 10 patients with RT from NHBD, with an average timing of warm ischemia of 35 min and average timing of cool ischemia 21 h. In the post-transplantation renal function study, 9 of then showed hemodilution and one an acute tubular necrosis (ATN) pattern. In most of the cases, the study was performed the day after the RT except for one that was performed on the 4th day (1.7 ± 1 days). Renal perfusion was conserved in every case. The renal graft maintained this type of record until post-RT day 7 (6.67 ± 0.57 days) and evolved towards ATN after day 10 (11.65 ± 1.5 days) and normal range on day 55 ± 51.1 post-transplantation. All patients supported the graft, with acceptable renal function, except one of then who was treated with transplantectomy due to a renal venous thrombosis. Conclusion: The renal function study showed "hemodilution" in the first post-transplantation in 90 % of the RT from NHBD. Evolution went from ATN to normality. The NHBD are adequate for transplantation, significantly shortening the waiting time for RN