Long-Term Follow-Up after Paediatric Kidney Transplantation and Influence Factors on Graft Survival: A Single-Centre Experience of 16 years
Long-Term Follow-Up after Paediatric Kidney Transplantation and Influence Factors on Graft Survival: A Single-Centre Experience of 16 years
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DOI：
10.1159/000487195
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发表时间：
2018-01-01
影响因子：
1.6
通讯作者：
Lingnau, Anja
中科院分区：
文献类型：
--
作者：
Friedersdorff, Frank;Koch, Therese-Marie;Lingnau, Anja
前言：评价儿童肾移植后移植物和患者的存活情况，并检测影响移植后时间的影响因素。材料和方法：我们分析了儿童肾移植后的长期存活率和并发症，并寻找移植肾功能的预测参数。结果：132例患者共行143例肾移植。移植失败的发生率为25%。慢性排斥是移植物丢失的主要原因(42.9%)。移植物存活率1年为92.2%，5年为85.5%，10年为71.1%，15年为62.1%。以下参数对移植物存活率有显著影响：移植数量(p=0.014)、移植年份(p<；1997年至2005年为0.0001)、移植后促红细胞生成素治疗(p=0.001)、低血压供者(p=0.027)、冷缺血时间(p=0.023)、吻合时间50分钟(p=0.008)、移植物功能延迟(p=0.003)和死亡供体(p=0.039)。死亡患者比例为5.6%。1年、5年、10年、15年生存率分别为99.3%、95.2%、94.2%、90.7%。各类感染(42.9%)是主要死亡原因。结论：恶性肿瘤和感染是儿童肾移植术后死亡的主要原因。为避免血管并发症，尤其是年轻受者(<；9岁)，冷缺血时间应尽可能短。(C)2018年S.Karger AG，巴塞尔。
Introduction: To evaluate graft- and patient survival after paediatric kidney transplantation and detecting influence factors, which affect the post-transplant time. Materials and Methods: We analysed long-term survival rates and complications after paediatric kidney transplantation and searched for predictive parameters for graft function. Results: In 132 patients, 143 kidney transplantations were performed. Graft failure occurred in 25%. Chronic rejections were the leading cause of graft loss (42.9%). Graft survival rates were 92.2% after 1 year, 85.5% after 5 years, 71.1% after 10 years and 62.1% after 15 years. The following parameters strongly influenced graft survival: number of transplants (p = 0.014), year of transplant (p < 0.0001 for 1997-2005), Epo-therapy post-transplant (p = 0.001), hypotension donor (p = 0.027), cold ischemia time (p = 0.023), anastomosis time >50 min (p = 0.008), delayed graft function (p = 0.003) and deceased donation (p = 0.039). The percentage of patients who died was 5.6%. Overall patient survival rates were 99.3% after 1 year, 95.2% after 5 years, 94.2% after 10 years and 90.7% after 15 years. Various types of infections (42.9%) were the main causes of death. Conclusions: The main causes of death after kidney transplantations in paediatric recipients are malignancy and infections. To avoid vascular complications especially in young recipients (< 9 years), the cold ischemia time should be as short as possible. (c) 2018 S. Karger AG, Basel.