中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2014年
9期
519-522
,共4页
陈传宝%袁小鹏%周健%韩明%王小平%焦兴元%王长希%何晓顺
陳傳寶%袁小鵬%週健%韓明%王小平%焦興元%王長希%何曉順
진전보%원소붕%주건%한명%왕소평%초흥원%왕장희%하효순
儿童%心脏死亡器官捐献%供者%肾移植
兒童%心髒死亡器官捐獻%供者%腎移植
인동%심장사망기관연헌%공자%신이식
Child%Donation after cardiac death%Donors%Kidney transplantation
目的 探讨儿童心脏死亡器官捐献(DCD)供者供肾移植的临床效果.方法 回顾性分析2010年2月至2013年10月间儿童DCD供者供肾移植的临床资料,共获取27例儿童供者的54只肾脏,进行肾移植48例,包括6例双肾整块移植和42例单肾移植.27例儿童供者中,男性19例,女性8例,年龄(10.5±5.2)岁(10个月～17岁),体质量(36.1±17.2)kg(10～65 kg);16例属于中国二类,11例属于中国三类;供肾热缺血时间为(17.4±4.7)min(11～30min),冷缺血时间为(6.8±3.3)h(3.5～20 h).48例受者中,男性30例,女性18例,年龄(38.2±15.7)岁(7～68岁),其中成人(满18岁)40例,儿童8例.结果 48例受者中,术后移植肾功能立即恢复27例,缓慢恢复17例,出现移植肾功能恢复延迟4例(8.3％).术后进行了(5.2±6.0)个月(1个月～3年)的随访,随访期间所有受者均存活,发生急性排斥反应7例,发生率为14.6％(7/48),1例受者因发生抗体介导的急性排斥反应导致移植肾功能丧失,其余6例经治疗后均逆转,未发生导致移植肾功能丧失和受者死亡的严重并发症;术后1年受者及移植肾存活率分别为100％(48/48)和97.9％(47/48).结论 儿童DCD供者供肾移植后的早期效果良好,儿童DCD供者是扩大供肾来源的有效途径.
目的 探討兒童心髒死亡器官捐獻(DCD)供者供腎移植的臨床效果.方法 迴顧性分析2010年2月至2013年10月間兒童DCD供者供腎移植的臨床資料,共穫取27例兒童供者的54隻腎髒,進行腎移植48例,包括6例雙腎整塊移植和42例單腎移植.27例兒童供者中,男性19例,女性8例,年齡(10.5±5.2)歲(10箇月～17歲),體質量(36.1±17.2)kg(10～65 kg);16例屬于中國二類,11例屬于中國三類;供腎熱缺血時間為(17.4±4.7)min(11～30min),冷缺血時間為(6.8±3.3)h(3.5～20 h).48例受者中,男性30例,女性18例,年齡(38.2±15.7)歲(7～68歲),其中成人(滿18歲)40例,兒童8例.結果 48例受者中,術後移植腎功能立即恢複27例,緩慢恢複17例,齣現移植腎功能恢複延遲4例(8.3％).術後進行瞭(5.2±6.0)箇月(1箇月～3年)的隨訪,隨訪期間所有受者均存活,髮生急性排斥反應7例,髮生率為14.6％(7/48),1例受者因髮生抗體介導的急性排斥反應導緻移植腎功能喪失,其餘6例經治療後均逆轉,未髮生導緻移植腎功能喪失和受者死亡的嚴重併髮癥;術後1年受者及移植腎存活率分彆為100％(48/48)和97.9％(47/48).結論 兒童DCD供者供腎移植後的早期效果良好,兒童DCD供者是擴大供腎來源的有效途徑.
목적 탐토인동심장사망기관연헌(DCD)공자공신이식적림상효과.방법 회고성분석2010년2월지2013년10월간인동DCD공자공신이식적림상자료,공획취27례인동공자적54지신장,진행신이식48례,포괄6례쌍신정괴이식화42례단신이식.27례인동공자중,남성19례,녀성8례,년령(10.5±5.2)세(10개월～17세),체질량(36.1±17.2)kg(10～65 kg);16례속우중국이류,11례속우중국삼류;공신열결혈시간위(17.4±4.7)min(11～30min),랭결혈시간위(6.8±3.3)h(3.5～20 h).48례수자중,남성30례,녀성18례,년령(38.2±15.7)세(7～68세),기중성인(만18세)40례,인동8례.결과 48례수자중,술후이식신공능립즉회복27례,완만회복17례,출현이식신공능회복연지4례(8.3％).술후진행료(5.2±6.0)개월(1개월～3년)적수방,수방기간소유수자균존활,발생급성배척반응7례,발생솔위14.6％(7/48),1례수자인발생항체개도적급성배척반응도치이식신공능상실,기여6례경치료후균역전,미발생도치이식신공능상실화수자사망적엄중병발증;술후1년수자급이식신존활솔분별위100％(48/48)화97.9％(47/48).결론 인동DCD공자공신이식후적조기효과량호,인동DCD공자시확대공신래원적유효도경.
Objective To explore the clinical effect of kidney transplantation from donation after cardiac death (DCD) of pediatric donors.Method The clinical data of kidney transplantation from DCD pediatric donors from February 2010 to October 2013 were retrospectively reviewed.We all obtained 54 kidneys from 27 pediatric donors and performed 48 kidney transplantations containing 6 enbloc kidney transplantations and 42 single kidney transplantations.These 27 pediatric DCD donors included 19 males and 8 females,with age of 10.5 ± 5.2 years old (10-17 years) and body mass was 36.1 ± 17.2 kg (10-65 kg),and there were 16 cases of China category Ⅱ and 11 cases of China category Ⅲ.The warm ischemic time was 17.4 ± 4.7 min (11-30 min) and cold ischemic time was 6.8 ± 3.3 h (3.5-20 h).There were 18 females and 30 males in 48 recipients:the age was 38.2 ± 15.7 years old (7-68 years old),and 40 of them were adults (over 18 years).Result No primary nonfunction appeared.The number of immediate graft function and slow graft function was 27 and 17,respectively.The incidence of delayed graft function 8.3％ (4 cases).During a follow-up period of 5.2 ± 6.0 months (1 month to 3 years),all recipients were alive,acute rejection occurred in 7 cases (14.6％) and renal graft loss due to antibody-mediated rejection in one case,and other grafts functioned well.The one-year survival rate of recipients and renal allograft was 100％ (48/48) and 97.9％ (47/48) respectively after transplantation.Conclusion The early clinical effect of kidney transplantation from pediatric DCD is excellent.The pediatric DCD donors can be used to expand the donor pool.
