Samhan M, Fathi T, Al-Kandari N, Buresley S, Nampoory M R N, Nair P, Halim M, Al-Mousawi M
Hamed Al-Essa Organ Transplantation Centre, Kuwait.
Transplant Proc. 2007 May;39(4):911-3. doi: 10.1016/j.transproceed.2007.03.042.
Renal transplantation is the preferred method for the treatment of children in end-stage renal disease (ESRD). In this retrospective study, we analyzed the results at our center.
Between November 1993 and June 2006, 86 children (50 boys and 36 girls) received organs from 50 living donors (LDTx) and 36 cadaveric donors (CDTx). Twenty children were <10 years. In addition to ESRD, some patients had one or more other high-risk factors, eg, abnormal lower urinary tract in 36 recipients (42%). The procedure was a preemptive transplantation in 28, and a retransplantation in 9 recipients. Induction immunosuppression used either antithymocyte globulin (43 cases) or anti-interleukin-2 receptor antibodies (20 cases).
Patients were followed for 6 to 150 months. There were 24 surgical complications (28%), 26 acute rejection episodes (33%), and 17 of systemic bacterial or viral infections. Two recipients died at 1 and 21 months. The 14 grafts were lost at 1 day to 87 months. The 1- and 10-year actuarial survival rates were 99% and 98%, respectively, for the recipients, and 88% and 84%, respectively, for the grafts. The 10-year actuarial graft survival rates were 98% in LDTx and 64% in CDTx; 86% in recipients >10 years old and 75% in recipients <10 years old. Abnormal urinary tract, pretransplantation dialysis, and transplant number showed no effect on graft survival. All pediatric recipients with functioning grafts are fully rehabilitated.
Renal transplantation is the preferred method of treatment for children in ESRD. Higher graft survival rates were achieved in older children and following LDTx.
肾移植是治疗儿童终末期肾病（ESRD）的首选方法。在这项回顾性研究中，我们分析了本中心的治疗结果。
1993年11月至2006年6月期间，86名儿童（50名男孩和36名女孩）接受了来自50名活体供者（LDTx）和36名尸体供者（CDTx）的器官。20名儿童年龄小于10岁。除ESRD外，一些患者还有一个或多个其他高危因素，例如36名受者（42%）存在下尿路异常。28例为抢先移植，9例为再次移植。诱导免疫抑制采用抗胸腺细胞球蛋白（43例）或抗白细胞介素-2受体抗体（20例）。
对患者进行了6至150个月的随访。有24例手术并发症（28%），26例急性排斥反应（33%），17例全身性细菌或病毒感染。2名受者分别在1个月和21个月时死亡。14个移植物在1天至87个月时丢失。受者的1年和10年实际生存率分别为99%和98%，移植物的1年和10年实际生存率分别为88%和84%。LDTx的10年实际移植物生存率为98%，CDTx为64%；10岁以上受者为86%，10岁以下受者为75%。尿路异常、移植前透析和移植次数对移植物存活无影响。所有移植肾功能良好的儿科受者均已完全康复。
肾移植是治疗儿童ESRD的首选方法。年龄较大的儿童和接受LDTx后移植物存活率更高。
