儿童心脏死亡器官捐献供者供肾移植48例报告  

Kidney transplantation from donation after cardiac death of pediatric donors

作　　者：陈传宝[1] 袁小鹏[1] 周健[1] 韩明[1] 王小平[1] 焦兴元[1] 王长希[1] 何晓顺[1] 

机构地区：[1]中山大学附属第一医院东院器官移植三区,广州510700

出　　处：《中华器官移植杂志》2014年第9期519-522,共4页Chinese Journal of Organ Transplantation

基　　金：卫生部部属（管）医院临床学科重点项目（2010159）;卫生部公益性行业科研专项基金（201002004）;广东省科技计划临床医学重点项目（2011A030400005）

摘　　要：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（10-65kg）；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（3．5～20h）。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。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.

关 键 词：儿童 心脏死亡器官捐献 供者 肾移植 

分 类 号：R726.5[医药卫生—儿科]