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在低体重儿科受者中移植成人尺寸的肾脏,其短期结果与尺寸匹配的移植物相当。

Transplantation of adult-sized kidneys in low-weight pediatric recipients achieves short-term outcomes comparable to size-matched grafts.

作者信息

Goldsmith P J, Asthana S, Fitzpatrick M, Finlay E, Attia M S, Menon K V, Pollard S G, Ridgway D M, Ahmad N

机构信息

Division of Surgery, Department of Transplant Surgery, St James's University Hospital, Leeds, UK.

出版信息

Pediatr Transplant. 2010 Nov;14(7):919-24. doi: 10.1111/j.1399-3046.2010.01375.x. Epub 2010 Sep 14.

DOI:10.1111/j.1399-3046.2010.01375.x
PMID:20840437
Abstract

Low-weight pediatric recipients are disadvantaged by scarcity of size-matched donors. ASK have been successfully used for pediatric recipients. We report the results of renal transplantation using ASK in low-weight pediatric recipients and compare outcomes in weight-matched and unmatched donor-recipient pairs. The outcomes of renal transplants using ASK grafts in low-weight (<20 kg) recipients from a single center over a 10-yr period were reviewed. Two groups, comprising recipients of grafts from weight-matched and mismatched donors, were compared. Primary outcome was one-yr graft survival. Secondary outcomes were one- and two-yr calculated eGFR, changes in recipient body weight, perioperative cardiovascular stability, rates of AR and DGF. Twenty-three low-weight recipients were transplanted. Eleven received ASK grafts from high-weight donors and 12 grafts from low-weight donors. One patient in each group had early graft loss. No significant difference was observed in rates of DGF, AR, one-yr graft or patient survival and perioperative cardiovascular parameters. ASK with considerable donor:recipient weight discrepancies can be safely transplanted into small pediatric recipients with comparable outcomes to grafts with less weight discrepancy.

摘要

低体重儿科受者因缺乏尺寸匹配的供体而处于不利地位。扩增后的肾脏(ASK)已成功应用于儿科受者。我们报告了在低体重儿科受者中使用ASK进行肾移植的结果,并比较了体重匹配和不匹配的供体-受者对的结局。回顾了一个单一中心在10年期间对低体重(<20 kg)受者使用ASK移植物进行肾移植的结果。比较了两组,一组是接受体重匹配供体移植物的受者,另一组是接受体重不匹配供体移植物的受者。主要结局是1年移植物存活率。次要结局是1年和2年计算的估算肾小球滤过率(eGFR)、受者体重变化、围手术期心血管稳定性、急性排斥反应(AR)和延迟性移植物功能恢复(DGF)的发生率。23名低体重受者接受了移植。11名接受了来自高体重供体的ASK移植物,12名接受了来自低体重供体的移植物。每组各有1例患者早期移植物丢失。在DGF发生率、AR发生率、1年移植物或患者存活率以及围手术期心血管参数方面未观察到显著差异。供体与受者体重差异较大的ASK可以安全地移植到小儿科受者体内,其结局与体重差异较小的移植物相当。

相似文献

1
Transplantation of adult-sized kidneys in low-weight pediatric recipients achieves short-term outcomes comparable to size-matched grafts.在低体重儿科受者中移植成人尺寸的肾脏,其短期结果与尺寸匹配的移植物相当。
Pediatr Transplant. 2010 Nov;14(7):919-24. doi: 10.1111/j.1399-3046.2010.01375.x. Epub 2010 Sep 14.
2
Kidney transplantation from pediatric donors: size-match-based allocation.小儿供体肾移植:基于大小匹配的分配
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The UNOS renal transplant registry.美国器官共享联合网络肾脏移植登记处。
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The UNOS Scientific Renal Transplant Registry.美国器官共享联合网络科学肾脏移植登记处。
Clin Transpl. 1999:1-21.
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Kidney grafts from donors ≤ 5 yr of age: single kidney transplantation for pediatric recipients or en bloc transplantation for adults?来自5岁及以下供体的肾移植:儿科受者行单肾移植还是成人行整块移植?
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引用本文的文献

1
Effect of donor-recipient size mismatch on long-term graft survival in pediatric kidney transplantation: a multicenter cohort study.供受者大小不匹配对小儿肾移植长期移植物存活的影响:一项多中心队列研究
Kidney Res Clin Pract. 2023 Nov;42(6):731-741. doi: 10.23876/j.krcp.23.170. Epub 2023 Nov 29.
2
Donor considerations in pediatric kidney transplantation.小儿肾移植中的供体考量
Pediatr Nephrol. 2021 Feb;36(2):245-257. doi: 10.1007/s00467-019-04362-z. Epub 2020 Jan 13.
3
Renal allograft survival rates in kidneys initially declined for paediatric transplantation.
儿童肾移植的肾移植存活率最初有所下降。
Pediatr Nephrol. 2018 Sep;33(9):1609-1616. doi: 10.1007/s00467-018-3969-4. Epub 2018 May 28.
4
Donor-recipient size mismatch in paediatric renal transplantation.小儿肾移植中的供受者大小不匹配
J Transplant. 2014;2014:317574. doi: 10.1155/2014/317574. Epub 2014 Feb 13.