Tayfur A C, Besbas N, Bilginer Y, Ozaltin F, Duzova A, Bakkaloglu M, Aki F T, Ozen S, Topaloglu R, Bakkaloglu A
Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Transplant Proc. 2011 Apr;43(3):847-9. doi: 10.1016/j.transproceed.2011.01.107.
Nephronophthisis (NPHP) is the most common genetic cause of end-stage renal disease (ESRD) in the first 3 decades of life. Treatment of patients with NPHP is symptomatic; kidney transplantation is the treatment of choice when ESRD is established. We report herein our center's experience with kidney transplantation for children with juvenile NPHP.
We retrospectively analyzed medical records of 9 renal transplant recipients with a primary diagnosis of juvenile NPHP confirmed by genetic analysis and/or renal biopsy findings in a single center from 1996 to 2010.
Of the 9 patients, 6 received a living related and 3 a cadaveric donor transplantation. Preemptive renal transplantation was performed in 7 patients. The median age of the patients was 13.38 ± 4.6 years; the median follow-up period was 17 months. Posttransplantation immusuppression comprised corticosteroids, a calcineurin inhibitor, and mycophenolate mofetil or azathioprine. One patient lost his renal graft owing to renal graft thrombosis, and grade II chronic allograft nephropathy was diagnosed by renal biopsy on the 62th day after renal transplantation in another patient. The median glomerular filtration rates after transplantation at 1, 3, and 5 years were 85, 75.2, and 83.2 mL/min/1.73 m(2), respectively.
We observed preserved graft functions for long periods among renal transplant recipients with juvenile NPHP. Chronic allograft nephropathy developed rarely on long follow-up.
肾单位肾痨(NPHP)是30岁前终末期肾病(ESRD)最常见的遗传病因。NPHP患者的治疗以对症治疗为主;当ESRD确诊后,肾移植是首选的治疗方法。我们在此报告本中心对青少年NPHP患儿进行肾移植的经验。
我们回顾性分析了1996年至2010年期间在单一中心接受肾移植的9例患者的病历,这些患者经基因分析和/或肾活检结果确诊为青少年NPHP。
9例患者中,6例接受了亲属活体供肾移植,3例接受了尸体供肾移植。7例患者接受了抢先肾移植。患者的中位年龄为13.38±4.6岁;中位随访期为17个月。移植后免疫抑制包括皮质类固醇、钙调神经磷酸酶抑制剂以及霉酚酸酯或硫唑嘌呤。1例患者因肾移植血栓形成失去了移植肾,另1例患者在肾移植后第62天经肾活检诊断为II级慢性移植肾肾病。移植后1年、3年和5年的中位肾小球滤过率分别为85、75.2和83.2 mL/min/1.73 m²。
我们观察到青少年NPHP肾移植受者的移植肾功能长期保持良好。长期随访中很少发生慢性移植肾肾病。