61例婴幼儿单肾供肾移植受者的临床观察  

Clinical observation of 61 single kidney transplants with donors from infants and young children to adults

作　　者：刘永光[1] 胡建敏[1] 陈桦[1] 李世超[1] 李民[1] 郭颖[1] 赵明[1] Liu Yongguang, Hu Jianmin, Chen Hua, Li Shichao, Li Min, Guo Ying, Zhao Ming.(Department of Organ Transplantation, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Chin)

机构地区：[1]南方医科大学珠江医院器官移植科,广州510282

出　　处：《中华器官移植杂志》2018年第4期197-202,共6页Chinese Journal of Organ Transplantation

摘　　要：目的 探讨婴幼儿单侧供肾给成人后移植肾生长发育及移植肾存活的状况.方法 回顾分析婴幼儿单侧供肾给61例成人肾移植的临床资料,受者分为婴儿供肾受者组（供者年龄≤1岁,24例）和幼儿供肾受者组（1＜供者年龄≤3岁,37例）,收集两组受者术后血清肌酐、多普勒B型超声波测量移植肾长径等资料,随访登记肾移植受者术后移植肾功能恢复延迟（DGF）、血管并发症、尿路并发症、尿蛋白、急性排斥反应及感染发生等并发症.结果 在1个月时婴儿供肾受者组血肌酐高于幼儿供肾受者组[（350.67±35.57） μmol/L与193.70±86.76） μmol/L];婴儿供肾受者组的移植肾长径小于幼儿供肾受者组[（78.29±4.68） mm与（93.62±5.57） mm];在3个月、6个月、1年、3年时两组血肌酐和移植肾长径比较,差异无统计学意义.婴儿供肾受者组发生DGF 16例（66.67％,16/24）,幼儿供肾受者组发生DGF14例（37.83％,14/37）,婴儿供肾受者组DGF发生率高于幼儿供受者肾组（P=0.037）;婴儿供肾受者组1个月、3个月、6个月、1年及3年采用彩色多普勒B型超声波检查测得移植肾长径分别为（78.29±4.68） mm、（91.21±5.34） mm、（96.21±7.69） mm、（100.30±7.42）mm及（102.35±8.54） mm;幼儿供肾受者组1个月、3个月、6个月、1年及3年彩色超声检查检查下测得移植肾长径分别为（93.62±5.57） mm、（97.27±7.50） mm、（101.89±7.51） mm、（103.52±8.19） mm及（100.86±5.51） mm,婴儿供肾受者组血管并发症发生率与幼儿供肾受者组比较,差异无统计学意义（P=0.652）;婴儿供肾受者组与幼儿供肾受者组尿路并发症比较,差异无统计学意义（P=0.554）;婴儿供肾受者组急性排斥反应4例（16.6％,4/24）,幼儿供肾受者组急性排斥反应7例（18.9％,7/37）;两组比较,差异无统计学意义（P=1.000）;婴儿供肾受者组发生肺部感染5例（20.8％,5/24）,1例为细菌感染,Objective To evaluate the growth and survival of single kidney transplants with donation after citizen death （DCD） donors from infants and children （〈3 years of age） to adults.Methods We retrospectively analyzed the data of single kidney transplants with donors from infants and young children to adults in our center.All the recipients were divided into infant donor group （≤3 years of age） and children donor group （1 year〈 age ≤3 years） in terms of the donor＇s age.The serum creatinine （SCr） level after surgery was determined and the major diameter of the kidney was measured by Doppler B ultrasonography.DGF,vascular complications,urinary tract complications,proteinuria,acute rejection,and infection were recorded during the follow-up period.Results There were 24 cases in infant donor group and 37 in children donor group.The mean follow-up period was 28 months.The SCr level at 1 st month post-transplantation was significantly higher in infant donor group than in children donor group （350.67 ± 35.57 μmol/L versus 193.70 ± 86.76 μmol/L）,and the major diameter （（X-）± s） of the kidney in children donor group was significantly greater than that in infant donor group （78.29 ± 4.68 mm versus 93.62 ± 5.57 mm）,but there was no significant difference during the subsequent 3-year follow-up period.The incidence of DGF in infant donor group was significantly higher than in children donor group,but there was significant difference in the rate of vascular complications,urinary tract complications,proteinuria,acute rejection,and infection between two groups.Conclusion The single kidney transplants from infants and young children to adults can grow rapidly,and their survival rate is relatively high.

关 键 词：婴幼儿供者 单肾移植 成人受苦 

分 类 号：R726.9[医药卫生—儿科]