儿童肾移植105例次单中心临床分析  

Kidney transplantation in children： a single center experience of 105 cases

作　　者：李军[1] 刘龙山[1] 傅茜[1] 张桓熙[1] 莫樱[2] 邓荣海[1] 张志崇[3] 费继光[1] 邓素雄[1] 邱江[1] 陈立中[1] 邓伟颖 尚文俊[4] 郑克立[1] 王长希[1] 

机构地区：[1]中山大学附属第一医院器官移植中心,广州510080 [2]中山大学附属第一医院儿科,广州510080 [3]中山大学附属第一医院小儿外科,广州510080 [4]郑州大学第一附属医院肾移植科

出　　处：《中华器官移植杂志》2016年第1期6-10,共5页Chinese Journal of Organ Transplantation

摘　　要：目的总结儿童肾移植临床特点和移植疗效，探讨相关临床问题。方法回顾性分析1990-2015年单中心105例次儿童肾移植（含肝肾联合移植3例）的供、受者资料，包括首次肾移植99例以及99例中再次肾移植6例。受者接受移植时最小年龄为3岁，中位年龄为14．3岁。105例中，传统尸体来源供肾42例，亲属活体供肾18例，公民逝世后供者器官捐献（DCD）供肾45例。结果受者1、3、5、10年存活率分别为96．1％、91．8％、90．0％和90．O％，移植肾1、3、5、10年存活率分别为92．1％、86．6%、84．1％和76．4％。DCD组、亲属活体供肾移植组和传统尸体肾移植组间的受者和移植肾存活率的差异均无统计学意义（P〉0．05）。随访期间死亡8例，其中5例患儿的死亡原因与其原发病或合并症密切相关。术后早期并发症以感染（23．8％）和急性排斥反应（16．2％）为主。结论儿童肾移植近远期疗效较好，DCD供肾已成为供肾主要来源。需注意患儿先天性和遗传性疾病，掌握移植适应证。Objective To analyze the clinical features and outcome ot pediatric kidney transplantation, and to explore the related clinical issues. Method The clinical data of 105 pediatric kidney transplants from 1990 to 2015 were retrospectively analyzed. There were 99 cases of primary transplantation and 6 cases of secondary transplantation. There were 3 cases of combined liver-kidney transplantation. The youngest recipient was 3 years old. The median age of pediatric recipients was 14. 3 years old. There were 42, 1B and 45 cases of kidney transplantation from conventional deceased donor, living-related donor and donation after citizen＇s death （DCD）, respectively. Result The patient and graft survival rate at I, 3, 5 and 10 years post-transplant was 96. 1%/92. 1%, 91.8%/86. 6%, 90. 0%/84. 1%, and 90. 0%/76. 4%, respectively. There was no significant difference in either patient or graft survival among pediatric kidney transplants from living donors, conventional deceased donors, or DCD. Five out of 8 deaths （62. 5%） were closely related to the recipients＂ comorbidities prior to kidney transplantation. The most common complications at early stage after transplantation were infection （23. 8%） and acute rejection （16. 2%）. Conclusion Kidney transplantation provides good short-term and long-term outcome for children with renal failure. DCD has become a main donor source for pediatric recipients. One should pay special attention to potential congenital or inherited comorbidities when estimating transplant indications for children.

关 键 词：肾移植 儿童 肾炎 肾病 存活率 

分 类 号：R726.9[医药卫生—儿科]