Türk böbrek donörlerinin demografik özellikleri ve alıcı ile verici akrabalık ilişkisinin postoperatif parametrelere etkisi: Tek merkez deneyimi

Year 2023, Volume: 18 Issue: 1, 100 - 107, 27.02.2023

Onur Açıkgöz , Mert Altınel

https://doi.org/10.33719/yud.2023;18-1-1230358

Abstract

Amaç: Son Dönem Böbrek Yetmezliği (SDBY) hastalarına uygulanabilecek en etkili tedavi yöntemi böbrek transplantasyonudur (KTx). Canlı vericiden yapılan böbrek nakillleri, tamamen sağlıklı bir insanın ameliyata dahil edilmesi nedeniyle özellikli bir cerrahidir. Biz de bu retrospektif çalışmada, donör nefrektomi (DNx) yapılan Türk donörlerde, verici ile akrabalık derecesinin postoperatif sonuçlara etkisini araştırmayı amaçladık.
Gereç ve Yöntemler: Çalışmaya sol DNx yapılan toplam 297 hasta dahil edildi. Çalışmaya dahil edilen hastalar verici ile akrabalık derecelerine göre 6 ayrı gruba ayrılarak istatistiksel değerlendirmeye tabi tutuldu : böbrek vericisi anneler olan 69 DNx vakası grup-1’e, babalar olan 29 vaka grup-2’ye, eşlerden yapılan 70 donör nefrektomi vakası grup-3’e, kardeşlerden yapılan 68 vaka grup-4’e, çocuklardan yapılan 31 vaka grup-5’e ve 2. derece ve daha uzak akrabalardan yapılan 30 DNx vakası grup-6’ya dahil edildi. Hastalara ait yaş, cinsiyet, eğitim seviyesi, operasyon süresi (ST), postoperatif 1. gün Vizüel Analog Skala (VAS) ağrı skoru, hastanede yatış süresi ve Quality of Life (QoL) verileri retrospektif incelenerek kaydedildi.
Bulgular: Donörlerin akrabalık derecesine göre dağılımına bakıldığında, donör nefrektomi operasyonunun en sık eşlere (%23.57), annelere (%23.23) ve kardeşlere (%22.9) uygulandığı görülmektedir. Donörlerin %59.26’sının kadın olduğu ve çoğunluğunun (%67.68) orta öğrenim ve üzeri bir eğitim seviyesine sahip olduğu saptanmıştır. Gruplar arasında VAS skorları, hastanede kalış süresi ve Qol-Mental Skor açısından anlamlı farklılık izlenmiştir.
Sonuç: Canlı böbrek donörlerinin alıcı ile akrabalık dereceleri, postoperatif erken dönemde psikolojik sağlıkları üzerinde etkili olmakta ve muhtemelen bu yolla da VAS skorlarını ve hastanede kalış sürelerini etkilemektedir. Böbrek donasyon sürecinden en az etkilenen vericilerin anneler olduğu söylenebilir.

Keywords

böbrek , transplantasyon , canlı böbrek donörü , akrabalık ilişkisi

Demographic characteristics of Turkish kidney donors and the impact of donor-recipient relationship on postoperative outcomes: A single-center experience

Abstract

Objective: Kidney transplantation (KTx) is the most effective treatment option for patients with end-stage renal disease (ESRD). Live donor kidney transplantation is unique as it involves healthy individuals who undergo a major surgery. This retrospective study seeks to investigate the effect of donor–recipient relationship on postoperative outcomes in Turkish donors undergoing laparoscopic donor nephrectomy (DNx).
Material and Methods: The study was conducted with a total of 297 patients who underwent left DNx. The patients included in the study were divided into six different groups based on the degree of relationship with the recipients: Sixty-nine cases of DNx involved mothers as kidney donors classified into group-1, 29 cases involving fathers into group-2, 70 cases involving spouses into group-3, 68 cases involving siblings into group-4, 31 cases involving children into group-5, and 30 cases involving second-degree and more distant relatives into group-6. Patients’ data including age, sex, education level, duration of surgery (ST), Visual Analog Scale (VAS) pain score at postoperative day 1, length of hospital stay (HS), and Quality of Life (QoL) were retrospectively analyzed and recorded.
Results: The groups had significant differences in terms of VAS scores, HS, and QoL-MS. Posthoc analysis was performed to find out which groups had significant differences. Results showed that group-1 had significantly lower VAS scores than group-2, group-3, and group-6. HS was significantly long in group-3 and group-6. QoL-MS was significantly lower in group-2 and group-6 than the other groups.
Conclusion: The degree of relationship of living kidney donors to recipients influences their psychological health in the early postoperative period and probably affects VAS scores and length of hospital stay. It can be argued that mothers are the group of donors least affected by the kidney donation process.

Keywords

kidney , transplantation , live donor , donor-recipient relationship

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