器官移植2017，Vol.8Issue(4)：289-294,310,7.DOI:10.3969/j.issn.1674-7445.2017.04.007
儿童供肾双肾移植临床效果研究
Clinical efficacy of en-bloc kidney transplantation from pediatric donor kidneys
摘要
Abstract
Objective To evaluate the clinical efficacy of en-bloc kidney transplantation from pediatric organ donation after death. Methods Clinical data of donors and recipients undergoing en-bloc kidney transplantation from pediatric donor kidneys were retrospectively analyzed. The 1-year survival rates of the recipient and grafted kidney were calculated. The recovery of renal function at postoperative 1 year was observed. The changes in the length of grafted kidney and incidence of postoperative adverse events were monitored. Results The 1-year survival rate of the recipients was 8/9, and 72% for the grafted kidney. During 1-year follow-up, the serum creatinine (Scr) level was down-regulated from (747± 170) μmol/L before transplantation to (83±27) μmol/L post-transplantation, the blood urea nitrogen concentration was decreased from (24.5±4.9) mmol/L to (6.8±2.0) mmol/L, and the length of transplanted kidney was increased from (61.1±9.8) mm to (100.3±1.7) mm. Two recipients suffered from delayed graft function(DGF) and restored after hemodialysis. Two cases developed acute rejection and healed after methylprednisolone shock therapy. One recipient presented with lung fungal infection at postoperative 2 weeks after transplantation, and was treated by the withdrawal of immunosuppressive agents and antibacterial treatment with poor clinical efficacy. Then the recipient died at 3rd month. One case had renal arterial thrombosis at postoperative 7 d, underwent nephrectomy at postoperative 10 d and returned to hemodialysis. At postoperative 1st month, one recipient suffered from thrombosis of unilateral renal artery. The grafted kidney in other side normally functioned and significantly grew in size at postoperative 6 months. In addition, two cases had ureterostenosis of the transplanted kidney, albuminuria in 2, abdominal aortic stenosis in 1 and urinary fistula in 1. All these symptoms were cured or alleviated after corresponding treatment. Conclusions The incidence of perioperative complications is relatively high in en-bloc kidney transplantation from pediatric organ donation after death, whereas the clinical efficacy of such kidney transplantation can be gradually increased along with the accumulation of clinical experience.关键词
儿童/供者/边缘供肾/肾移植/双肾整体移植/围手术期/并发症/血液透析Key words
Child/Donor/Marginal kidney donor/Kidney transplantation/En-bloc kidney transplantation/Perioperative period/Complication/Hemodialysis分类
医药卫生引用本文复制引用
尚文俊,索敬钧,王志刚,徐飞,谢红昌,刘磊,丰永花,王军祥,丰贵文..儿童供肾双肾移植临床效果研究[J].器官移植,2017,8(4):289-294,310,7.基金项目
国家自然科学基金(U1304810) （U1304810）
