泌尿外科杂志(电子版)
泌尿外科雜誌(電子版)
비뇨외과잡지(전자판)
JOURNAL OF UROLOGY FOR CLINICIAN(ELECTRONIC VERSION)
2015年
2期
16-21
,共6页
刘永光%胡国杰%刘丁%胡建敏%陈桦%李世超%范礼佩%李留洋%岳良升%郭颖%李民%赵明
劉永光%鬍國傑%劉丁%鬍建敏%陳樺%李世超%範禮珮%李留洋%嶽良升%郭穎%李民%趙明
류영광%호국걸%류정%호건민%진화%리세초%범례패%리류양%악량승%곽영%리민%조명
肾移植%儿童供者%单侧供肾
腎移植%兒童供者%單側供腎
신이식%인동공자%단측공신
Kidney transplant%Pediatric donors%Single pediatric kidney
目的:评估体重<15kg的儿童DCD(公民逝世后器官捐献,包括脑死亡捐献和心脏死亡捐献)供者单侧供肾用于成人肾移植的早期安全性及临床效果。方法回顾分析本院2013年2月至2015年2月间行体重<15 kg的儿童供肾成人肾移植18例(儿童供肾组),与同期成人供肾成人肾移植62例(成人供肾组)的临床资料,分析两组患者术后并发症;1个月、3个月、6个月及1年移植肾eGFR;术后6个月及1年人、移植肾存活率;儿童供肾组术后移植肾长径、eGFR的变化情况,蛋白尿、血尿发生情况。结果儿童供肾组DGF、AR、血管及泌尿系并发症发生率分别为22.22%、5.56%、5.56%和5.56%,成人供肾组为20.03%、3.26%、0%和0%(P均>0.05);所有受者观察期间均未死亡,术后1个月儿童供肾组eGFR明显低于成人供肾组(P<0.05),术后3个月、6个月及1年,两组eGFR无差异(P>0.05)。儿童供肾组术后6个月及1年移植物存活率分别为93.80%和93.80%,而成人供肾组为98.20%和98.20%(P>0.05);儿童供肾组移植肾eGFR、长径与术后时间呈正相关增长,观察期内儿童供肾组蛋白尿发生率与成人组相当,血尿发生率高于成人组。结论本组体重<15 kg的儿童DCD单侧供肾成人肾移植术后并发症、功能(依据eGFR评价)与成人组相当,供肾长径及移植肾eGFR在术后3~6个月可增至成人水平,低体重儿童单侧供肾成人肾移植手术并发症率低,近期效果满意,远期效果有待进一步观察。
目的:評估體重<15kg的兒童DCD(公民逝世後器官捐獻,包括腦死亡捐獻和心髒死亡捐獻)供者單側供腎用于成人腎移植的早期安全性及臨床效果。方法迴顧分析本院2013年2月至2015年2月間行體重<15 kg的兒童供腎成人腎移植18例(兒童供腎組),與同期成人供腎成人腎移植62例(成人供腎組)的臨床資料,分析兩組患者術後併髮癥;1箇月、3箇月、6箇月及1年移植腎eGFR;術後6箇月及1年人、移植腎存活率;兒童供腎組術後移植腎長徑、eGFR的變化情況,蛋白尿、血尿髮生情況。結果兒童供腎組DGF、AR、血管及泌尿繫併髮癥髮生率分彆為22.22%、5.56%、5.56%和5.56%,成人供腎組為20.03%、3.26%、0%和0%(P均>0.05);所有受者觀察期間均未死亡,術後1箇月兒童供腎組eGFR明顯低于成人供腎組(P<0.05),術後3箇月、6箇月及1年,兩組eGFR無差異(P>0.05)。兒童供腎組術後6箇月及1年移植物存活率分彆為93.80%和93.80%,而成人供腎組為98.20%和98.20%(P>0.05);兒童供腎組移植腎eGFR、長徑與術後時間呈正相關增長,觀察期內兒童供腎組蛋白尿髮生率與成人組相噹,血尿髮生率高于成人組。結論本組體重<15 kg的兒童DCD單側供腎成人腎移植術後併髮癥、功能(依據eGFR評價)與成人組相噹,供腎長徑及移植腎eGFR在術後3~6箇月可增至成人水平,低體重兒童單側供腎成人腎移植手術併髮癥率低,近期效果滿意,遠期效果有待進一步觀察。
목적:평고체중<15kg적인동DCD(공민서세후기관연헌,포괄뇌사망연헌화심장사망연헌)공자단측공신용우성인신이식적조기안전성급림상효과。방법회고분석본원2013년2월지2015년2월간행체중<15 kg적인동공신성인신이식18례(인동공신조),여동기성인공신성인신이식62례(성인공신조)적림상자료,분석량조환자술후병발증;1개월、3개월、6개월급1년이식신eGFR;술후6개월급1년인、이식신존활솔;인동공신조술후이식신장경、eGFR적변화정황,단백뇨、혈뇨발생정황。결과인동공신조DGF、AR、혈관급비뇨계병발증발생솔분별위22.22%、5.56%、5.56%화5.56%,성인공신조위20.03%、3.26%、0%화0%(P균>0.05);소유수자관찰기간균미사망,술후1개월인동공신조eGFR명현저우성인공신조(P<0.05),술후3개월、6개월급1년,량조eGFR무차이(P>0.05)。인동공신조술후6개월급1년이식물존활솔분별위93.80%화93.80%,이성인공신조위98.20%화98.20%(P>0.05);인동공신조이식신eGFR、장경여술후시간정정상관증장,관찰기내인동공신조단백뇨발생솔여성인조상당,혈뇨발생솔고우성인조。결론본조체중<15 kg적인동DCD단측공신성인신이식술후병발증、공능(의거eGFR평개)여성인조상당,공신장경급이식신eGFR재술후3~6개월가증지성인수평,저체중인동단측공신성인신이식수술병발증솔저,근기효과만의,원기효과유대진일보관찰。
Objective To analyze the outcomes of adult recipients who received single kidney from pediatric donors weighting less than 15kg. Methods We retrospectively analyzed the outcome of 18 adult recipients of sin-gle kidneys from donors weighing less than 15 kg (study group)with 62 recipients receiving an allograft from a-dult deceased donors (control group)from February 2013 to February 2015. Results There were no deaths in two groups. The eGFR was lower in study group at 1 month (P<0. 05)but there are no difference at 3 m,6 m and 1 year(P>0. 05)between in both groups. The incidence of DGF,AR vascular and urological complications were 22. 22%,5. 56%,5. 56%,5. 56% and 20. 03%,3. 26%,0%,0%in study group and control groups, respectively (P>0. 05). 6-month,and 1-year graft survival rate was 93. 80% and 93. 80% in study group, and that was 98 . 20%and 98 . 20% in control group ,respectively (P>0 . 05 ). The kidney lengthes were posi-tively correlated with time. Urinary albumins were comparable between the two groups up at 1m,at 3 m,6 m and 1 year,but hematuresis rates were higher in the study group than the control group (P<0. 05). Conclu-sions Transplantation of single pediatric kidneys from donors weighing less 15 kg into adult recipients provides excellent intermediate-term outcomes and low complications incidence rates. Hematuresis rates might indicate late-onset hyperfiltration injury,so maybe it is a promising pathway to expand the organ donor pool.