Kidney Transplantation from Pediatric Donors in a Single Chinese Center
Kidney Transplantation from Pediatric Donors in a Single Chinese Center
复制标题
在单一中国中心进行儿科捐赠者的肾脏移植。
DOI：
10.1007/s12013-014-0118-y
复制
发表时间：
2014-12-01
影响因子：
2.6
通讯作者：
Shang, Wen-jun
中科院分区：
文献类型：
--
作者：
Li, Jin-feng;Liu, Jia;Shang, Wen-jun
报告中国单个中心儿童脑心源性死亡供体（DBCD）肾移植的临床结局，并探讨其扩大器官供体库的可行性。2011年8月至2013年10月在郑州大学第一附属医院接受移植的18例受者，接受单次DBCD供体移植，年龄范围为1.5至13岁。肾功能表示为血清肌酐，血尿素氮以及eGFR值在1，2周以及1，3，6，和12个月后移植进行了评价。同时通过超声检查监测移植物大小。此外，还评估了移植物功能延迟恢复、急性排斥反应、手术并发症以及患者和移植物存活率。DBCD供体的主要原因包括6例严重脑外伤和3例脑出血。DBCD供体的平均年龄为（7.2 +/-A3.4）岁（范围1.5-13）。DBCD供体的平均体重为（29.8 +/-A15.3）千克（范围13-67）。DBCD供体的平均身高为（118.3 +/-A27.8）cm（范围70-173）。为避免热缺血时间，对DBCD供体应用ECMO，应用时间为（79.8 ± 44.5）（32-180）min。其中，16名受者为儿科，2名受者为成人。受体的平均年龄为（14.6 +/-A9.7）岁（范围4-47）。受体的平均体重为（31.9 +/-A12.4）千克（范围11-54）。受体平均身高为（138.0 ± 23.7）cm（84-172）cm。除1例受者发生急性排斥反应外，其余受者肾功能均在术后1周内恢复正常。术后2周和3个月分别发现2例肾动脉狭窄。术后分别随访8个月和12个月，无复发，1例发生输尿管漏。5周后，经充分引流和延长留置导管后，输尿管漏愈合。移植物的大小显着和持续增加，在第一年，特别是在第一个3个月后移植。18例受者末次随访时均存活。其中16例术后随访12个月，1年受体/移植物存活率为100%。使用来自小儿DBCD的单肾移植物可以产生良好的短期结果。
To report clinical outcomes of kidney transplantation from pediatric brain and cardiac death donors (DBCD) in a single Chinese center and to investigate its feasibility to expand organ donor pool. 18 recipients, transplanted between August 2011 and October 2013 in the First Affiliated Hospital of Zhengzhou University, receive a single graft from DBCD donors age ranged from 1.5 to 13 years old. Renal function expressed as serum creatinine, blood urea nitrogen as well as eGFR values at 1, 2 weeks as well as 1-, 3-, 6-, and 12-months post-transplantation was evaluated. Graft size was also monitored at the same time by ultrasonography. In addition, delayed graft function, acute rejection, surgical complication as well as patient and graft survival were also assessed. The primary causes of DBCD donors included six cases of severe brain trauma and three cases of cerebral hemorrhage. The mean age of DBCD donors was (7.2 +/- A 3.4) years (range 1.5-13). The mean weight of DBCD donors was (29.8 +/- A 15.3) kilogram (range 13-67). The mean height of DBCD donors was (118.3 +/- A 27.8) centimeter (range 70-173). ECMO was applied to DBCD donors to avoid warm ischemia time and the applicating time was (79.8 +/- A 44.5) (range 32-180) minutes.There were seven males and 11 females recipients. Among which, 16 recipients were pediatrics and two recipients were adults. The mean age of the recipients was (14.6 +/- A 9.7) years (range 4-47). The mean weight of recipients was (31.9 +/- A 12.4) kilogram (range 11-54). The mean height of recipients was (138.0 +/- A 23.7) centimeter (range 84-172). Renal function recovered to normal within the first-week post-operation except one recipient which occurred acute rejection. Two cases of renal artery stenosis were found 2-week and 3-month post-transplantation, respectively. They subsequently underwent ballon angioplasty and followed up for 8 and 12 months, respectively, and no recurrence was found. One recipient developed ureteral leak. Five weeks later, the ureter leak healed after adequate drainage and prolongation of indwelling catheter. Graft size significantly and continuously increased during the first year, especially in the first 3-month post-transplantation. All the 18 recipients are alive at the last follow-up. Among which, 16 recipients are followed up for 12 months and 1-year recipient/graft survival rate is 100 %. The use of single kidney graft from pediatric DBCD could yield good short-term results.