Salvatierra Oscar, Concepcion Waldo, Sarwal Minnie M
Pediatr Nephrol. 2008 Dec;23(12):2107-9. doi: 10.1007/s00467-008-0951-6. Epub 2008 Aug 8.
Children with end-stage renal disease and inferior vena cava (IVC) thrombosis are rare, and their condition is complex and high risk for renal transplantation. Detailed imaging studies of the recipient's abdominal vasculature should be carried out prior to transplantation, followed by careful pre-operative joint planning by the pediatric transplant surgeon and nephrologist. Critical decisions need to be made as to whether a deceased child's kidney or an adult-sized kidney is to be used, and if the latter, whether it should be from a deceased or living donor. In addition, the contemplated site of the donor's renal vein anastomosis needs to be determined with a consideration of the possible consequences of the various choices. Sixteen cases of renal transplantation in children with pre-existing IVC thrombosis are reviewed, including the three reported by Shenoy et al. in this journal. With a full understanding of the difficulties noted, renal transplantation in a small child with IVC thrombosis can be successful. However, it requires thorough recipient assessment, coupled with a careful and thoughtful examination of options, to determine the best possible approach to the transplantation.
患有终末期肾病且伴有下腔静脉（IVC）血栓形成的儿童非常罕见，他们的病情复杂，肾移植风险高。移植前应对受者的腹部血管系统进行详细的影像学检查，随后由小儿移植外科医生和肾病学家进行仔细的术前联合规划。对于是使用已故儿童的肾脏还是成人尺寸的肾脏，以及如果使用后者，是来自已故供体还是活体供体，都需要做出关键决策。此外，在考虑各种选择可能产生的后果的情况下，需要确定供体肾静脉吻合的预期部位。本文回顾了16例患有IVC血栓形成的儿童肾移植病例，包括Shenoy等人在本期刊上报道的3例。在充分了解所指出的困难的情况下，患有IVC血栓形成的幼儿进行肾移植可以成功。然而，这需要对受者进行全面评估，并仔细、深入地考虑各种选择，以确定最佳的移植方法。
