Shi Xiaofeng,Du Qing,Tu Jinpeng,et al.Clinical outcomes of pediatric en bloc kidney transplantation[J].Journal of Clinical Pediatric Surgery,2022,21(10):974-979.[doi:10.3760/cma.j.cn101785-202202044-013]
小儿双供肾整体移植的临床疗效分析
- Title:
- Clinical outcomes of pediatric en bloc kidney transplantation
- Keywords:
- En Bloc Kidney Transplantation (EBKT); Complications; Proteinuria; Pediatric Donor; Single-Kidney Transplantation (SKT)
- 摘要:
- 目的 总结和分析小儿双供肾整体移植的临床疗效,并探讨经验和教训。方法 回顾性分析天津市第一中心医院肾移植科2011年7月至2022年1月收治的36例小儿双供肾整体移植患者的临床资料。主要观察移植肾存活率、移植肾丢失以及泌尿系统并发症发生率,还包括蛋白尿,出血等。随访3年,观察患者生存率及血清肌酐变化。结果 术后1年、3年的移植物存活率均为83%(30/36),移植受者存活率均为100%(36/36),移植物长期存活的30例受者中,术后3年血肌酐水平持续下降。移植肾丢失发生率为16.7%(6/36),其他并发症包括泌尿系统并发症16.7%(6/36)、出血11.1%(4/36)等。蛋白尿的发生比例逐步下降,大部分在随访期间消失。结论 小儿双供肾整体移植具有良好的长期移植肾功能和存活率,是一个增加供体库的可行、有效方法。
- Abstract:
- Objective To summarize the clinical outcomes of en bloc kidney transplantation (EBKT) from pediatric donors at a single center and summarize the experiences and lessons.Methods Thirty-six pediatric to adult EBKTs were performed between July 2011 and February 2022.The primary outcome variable was en-bloc allograft survival rate.Secondary outcome variables included incidence of graft failure and incidence of urological complications.The postoperative occurrences of such complications as proteinuria and hemorrhage were recorded along with overall survival and serum creatinine during 3-year follow-ups.Results Both 1/3-year graft survival rates were 83%(30/36) and the recipient survival rate was 100%(36/36).And 30 recipients achieved long-term graft survival.Improvement of creatinine level was noted up until the third year.Graft failure was a serious posttransplant complication with an incidence of 16.7%(6/36).Other complications included urological complications (16.7%,6/36) and hemorrhage (11.1%,4/36).The percentage of patients with proteinuria declined gradually and proteinuria subsided largely during follow-ups.Conclusion EBKT from pediatric donors is associated with excellent long-term allograft and patient survivals.It is a feasible strategy of expanding the transplant donor pool.
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备注/Memo
收稿日期:2022-2-21。
基金项目:天津市卫生健康委员会科技项目(KJ20128、KJ20122、KJ20111、ZC20227、KJ20090)
通讯作者:莫春柏,Email:mochunbaitj@126.com