儿童心脏死亡器官捐献供者单肾成人肾移植的疗效  

Effect of single kidney transplantation from cardiac death pediatric donors to adult recipients

作　　者：周结学[1] 刘东[1] 吴家清[1] 蒙善东[1] 申升[1] 邓庚国 马娟[1] 郑克立[1] 

机构地区：[1]广东省第二人民医院器官移植科,广州市510317

出　　处：《实用医学杂志》2017年第1期14-17,共4页The Journal of Practical Medicine

基　　金：广东省医学科学研究基金资助项目(编号:B2016104)

摘　　要：目的:观察儿童心脏死亡器官捐献(DCD)供者单肾成人移植的早期临床疗效。方法:回顾性分析广东省第二人民医院器官移植中心2010年1月至2016年5月儿童DCD供者单肾成人移植供、受者临床资料。6例儿童DCD供者中位年龄9岁(5~15岁),均捐献给相同血型受者。12例受者中位年龄38岁(21~65岁),男4例,女8例,均为首次肾移植,群体反应性抗体均阴性,HLA错配数1~4个。均采用右侧髂窝移植法。结果:12例受者手术均获成功。术后肾功能恢复均较顺利,未发生急性排斥反应、移植肾原发性无功能和移植肾功能延迟。其中5例为移植肾功能5 d内恢复正常,5例为移植肾功能10 d逐步恢复,有2例缓慢恢复。1例受者术后出现尿漏,经通畅引流后尿漏停止。1例受者切口延迟愈合,换药后Ⅱ期愈合。术后随访1~36个月,受者和移植肾全部存活,所有受者肾功能均正常。结论:儿童DCD供者单肾成人移植早期临床疗效良好,是一种扩大供者来源的良好途径。Objective To observe the early clinical effect of single kidney transplantation from cardiac death pediatric donors to adult recipients. Methods Clinical data of 6 single kidney transplantations from cardiac death pediatric donors in adult recipients in Department of Organ Transplantation, Guangdong Province No.2 People＇s hospital were retrospectively analyzed, the transplant operations were carried out between January 2010 to may 2016.The median age of 6 pediatric donors was 9 years （5 years to 15 years）. All recipients had the same blood type. The median age of 12 recipients was 38 years （21 years to 65 years）, with 4 man and 8 women. All recipients received kidney transplantation for the first time, and overall reactive antibodies（PRA） were negative, with HLA mismatch between lto 4. All recipients received single kidney transplantation in fight fossa iliaca. Results 12 kidney transplantations were successful. The renal allografts recovered successfully without acute renal rejection, delayed graft function or primary nonfunction. Renal function of 5 of recipients immediately recovered in 5 days, 5 recovered in 10 days, and 2 recovered slowly. 1 recipient manifested urine leak and recovered after drainage. 1 case developed delayed incision healing and recovered after dressing at stage Ⅱ. All patients and renal grafts functions were wellnormal during follow-up period between 1 month to 36 months. Conclusion The early clinical effect of single kidney transplantation from cardiac death pediatric donors to adult recipients is good and could be a promising pathway to expand the organ donor sources.

关 键 词：心脏死亡器官捐献 儿童供者 单肾成人移植 

分 类 号：R699.2[医药卫生—泌尿科学]