Abstract:

Objective To analyze the safety of renal transplant from donors with primary central nervoussystem（CNS）tumors. Methods We retrospectively analyzed the clinical data of 21 donors with primary CNS tumors and the 28 corresponding renal recipients and 2 stimultaneous pancreas-kidney transplantation（SPK）between Apr 2014 and Jun 2018 in The Third Medical Center of the PLA General Hospital. Results The average age was（25.8 ± 16.7）years，including 13 males and 8 females. Nine donors underwent surgical tumor resection before donation. The pathological classification of these tumors included ：pineal benign tumor，spinal benign tumor，craniopharyngioma benign tumor，astrocytoma grade Ⅱ and grade Ⅲ，meningioma grade Ⅰ. Two patients underwent simultaneous pancreas-kidney transplantation，one patient recovered smoothly，splenic venous thrombosis was found in the other patient on the first day after surgery，and embolectomy was performed. The postoperative recovery was

smooth. The pancreas and kidney functions of the two patients were normal. Among twenty-eight kidney transplant recipients，one patient suffered from DGF after operation，the kidney function recovered after dialysis，one patient had urinary leakage and was cured by operation. One patient with lupus nephritis underwent kidney transplantation 8 years ago，and now lupus nephritis recurred，the donor was a 7-year-old boy who was diagnosed with brain stem glioma and no craniotomy was performed，lupus nephritis recurred again after 1 year，and dialysis was restored. Other patients recovered smoothly. At present，The renal function of 27 recipients was normal and no CNS recurrence was found in the follow-up. Conclusion Tumor transmission of renal allograft from donors with primary CNS tumors was inevitable but with low risk，this kind of donors could be used with careful assessment and it could effectively expand the source of kidney，reduce patient waiting time and mortality，but the donor kidney should be carefully evaluated and screened.

Key words: Kidney transplant, Central nervous system neoplasms, Neoplasm metastasis

摘要：

目的 探讨原发性中枢神经系统肿瘤供者供肾移植的安全性。方法 回顾性分析解放军总医院第三医学中心移植中心 2014 年 4 月—2018 年 6 月间的 21 例原发性中枢神经系统肿瘤供者的临床资料 ,以及 2 例胰肾联合移植和 28 例肾移植受体的随访资料。结果 供体 21 例，男性 13 例，女性 8 例，平均年 龄（25.8±16.7）岁，其中 9 例捐献前行手术切除治疗，病理显示松果体良性肿瘤 1 例，脊髓良性肿瘤 1 例，颅咽管瘤良性肿瘤 1 例，星型胶质细胞瘤Ⅱ级 3 例及Ⅲ级 1 例，脑膜瘤Ⅰ级 2 例。受者中 2 例胰肾联合移植，1 例手术后恢复顺利，1 例手术后第一天形成脾静脉血栓，手术取出，术后患者恢复顺利，2 例患者胰肾功能均正常。28 例肾移植受者中，1 例患者手术后发生移植肾功能恢复延迟，透析后 2 周肾功能恢复正常，1 例患者尿漏行二次手术修补，1 例肾移植 8 年后狼疮肾炎复发，行二次肾移植，供体为 7 岁男孩，诊断脑干胶质瘤，未行开颅手术治疗，肾移植手术后 1 年狼疮肾炎再次复发，恢复透析，其他患者手术后恢复顺利，目前随访 3 个月～ 4 年 4 个月，27 例受体肾功能均正常，随访无肿瘤复发。结论 中枢神经肿瘤供肾肿瘤发生率低，可以有效扩大供肾来源，减少患者等待时间以及等待患者病死率，但对供肾应进行严密的评估和筛选。

关键词: 肾移植 , 原发性中枢神经系统肿瘤 , 肿瘤转移