Abstract:

Objective To investigate the clinical features of kidney transplantation of small pediatric donors into pediatric recipients. Methods A retrospective analysis of clinical data and follow-up status in50 kidney transplants from small pediatric donors into pediatric recipients was performed. Results Based on their transplantation type，the patients were divided into two groups: the single kidney transplantation （SKT, 37 cases）group and the en bloc kidney transplantation（EBKT，13 cases）group. In SKT group，postoperative complications included vascular thrombosis in 1 patient（2.7%），ureteral stenosis in 1 patient（2.7%），delayed graft function（DGF）in 17 patients（45.9%）and acute rejection（AR）in 4 patients （10.8%）. In EBKT group，postoperative complications included vascular thrombosis in 4 patients（30.8%），urine leak in 2 patients（15.4%），DGF in 2 patients（15.4%）and acute rejection in 2 patients（15.4%）. At last follow-up，patients survival rates were 100% in both groups，whereas grafts survival rates were 94.6% in SKT group 3-31 months and 76.9% in EBKT group（4-44 months）. At last follow-up，the mean serum creatinine in SKT and EBKT groupwere（67.9±23.1）μmol/L and（56.2±18.7）μmol/L，respectively. Conclusions Favorable outcomes can be obtained from transplantation from small pediatric donors. The use of this donor population for pediatric recipients should be encouraged.

摘要：

目的 探讨目前儿童肾移植中婴幼儿供肾的临床应用情况。方法 回顾性分析了 50 例婴幼儿供肾儿童肾移植的临床资料和随访情况。结果 根据移植术式的不同分为单肾移植组（37 例）和双肾整块移植组（13 例）。单肾移植组的术后并发症包括血管栓塞 1 例（占 2.7%），输尿管梗阻 1 例（占 2.7%），肾功能延迟恢复 17 例（占 45.9%）和急性排斥反应（AR）4 例（占 10.8%）。双肾整块移植组患者的术后并发症包括血管栓塞 4 例（占 30.8%），尿瘘 2 例（占 15.4%），肾功能延迟恢复 2 例（占 15.4%），AR 2 例（占 15.4%）。单肾移植组术后随访 3 ～ 31 个月，人、肾的存活率分别为 100% 和 94.6%，末次随访时血肌酐为（67.9±23.1）μmol/L ；双肾整块移植组术后随访 4 ～ 44 个月，人、肾存活率分别为 100% 和 76.9%，末次随访时血肌酐为（56.2±18.7）μmol/L。结论 婴幼儿供肾在儿童肾移植中的应用可有效缓解我国移植器官短缺的问题，值得进一步深入研究。