Successful resumption of peritoneal dialysis following living donor liver transplantation in children with end-stage renal disease
Successful resumption of peritoneal dialysis following living donor liver transplantation in children with end-stage renal disease
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终末期肾病儿童活体肝移植后成功恢复腹膜透析
DOI：
10.1111/petr.12897
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发表时间：
2017
影响因子：
1.3
通讯作者：
Kasahara Mureo
中科院分区：
文献类型：
--
作者：
Kanazawa Hiroyuki;Fukuda Akinari;Sato Mai;Ishimori Shingo;Sasaki Kengo;Uchida Hajime;Shigeta Takanobu;Mali Vidyadhar Padmakar;Sakamoto Seisuke;Ishikura Kenji;Kasahara Mureo
需要RRT的ESRD儿童通常由PD管理，因为HD很难进入血管，而且需要相对较大的体外血量。腹部大手术可能会导致腹膜损伤和随之而来的粘连，从而降低腹膜的解剖能力和跨腹膜的运输能力。在这里，我们报告了两名儿科患者在LDLT后成功恢复PD。终末期肾病的病因分别为PH1和幼年性肾炎。两名患者均在LDLT前接受PD治疗。从LDLT前3天开始PD转为HD，术后分别于第13天和第28天恢复PD。LDLT前后维持PD每周Kt/V尿素。患者继续接受PD治疗，效果良好，无并发症。在LDLT期间，细致的术中技术可以通过保留腹膜的完整性和有效的运输能力来恢复术后PD，而不会增加腹膜炎的风险。
Children with ESRD in need of RRT are commonly managed by PD due to difficulty with vascular access for HD and the relatively large extracorporeal blood volume required. Major abdominal surgery may result in injury to the peritoneum and consequent adhesion, thereby resulting in a reduction in the anatomical capacity and transport capability across the peritoneal membrane. Here, we report successful resumption of PD after LDLT in two pediatric patients. The causes of ESRD were PH1 and juvenile nephronophthisis, respectively. Both patients were managed by PD prior to LDLT. PD was converted to HD starting three days before LDLT and was continued postoperatively until resumption of PD on days 13 and 28, respectively. The PD weekly Kt/V urea was maintained before and after LDLT. The patients continued to do well on PD without complications. Meticulous intra‐operative techniques during LDLT allow postoperative PD resumption by preservation of peritoneal integrity with effective transport capability and without added risk of peritonitis.