Donckerwolcke R A
Division of Nephrology, Wilhelmina Kinderziekenhuis, University of Utrecht, The Netherlands.
Child Nephrol Urol. 1991;11(3):179-84.
Excellent survival data and rewarding rehabilitation have been reported following kidney transplantation. Annual mortality decreases with time after transplantation and has dropped below 2% in children and below 3% in young adults. No major single cause of death has been identified. Short-term graft survival rates are still improving but no major breakthrough in long-term graft maintenance has been achieved. The major cause of graft failure is chronic rejection. Major causes of morbidity in long-term graft recipients are: hypertension occurring in 65-75% of the recipients, avascular necrosis of the bone resulting in severe disabling in 4% of transplant recipients and growth retardation. Also, in patients receiving a kidney transplant during childhood, an increased risk of de novo malignancy development was reported. Full rehabilitation is often hampered by physical disabilities and will restrict social life. However, the possibility of obtaining employment is not different from that of the general population. The evaluation of morbidity in long-term kidney transplant survivors requires the collaboration of larger pediatric transplantation centers.
肾移植后已报告了出色的生存数据和良好的康复效果。移植后的年死亡率随时间下降，儿童年死亡率已降至2%以下，年轻成年人年死亡率已降至3%以下。尚未确定主要的单一死亡原因。短期移植物存活率仍在提高，但在长期移植物维持方面尚未取得重大突破。移植物失败的主要原因是慢性排斥反应。长期移植物接受者发病的主要原因包括：65-75%的接受者出现高血压，4%的移植接受者因骨缺血性坏死导致严重残疾，以及生长发育迟缓。此外，据报告，儿童期接受肾移植的患者发生新发恶性肿瘤的风险增加。完全康复常常受到身体残疾的阻碍，并会限制社交生活。然而，获得就业的可能性与普通人群并无差异。对长期肾移植幸存者发病情况的评估需要更大的儿科移植中心之间的合作。
