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伊朗儿童肾移植的结果:一份全国多中心报告

Outcome of renal transplantation in children: a multi-center national report from Iran.

作者信息

Otukesh Hasan, Hoseini Rozita, Rahimzadeh Nahid, Fereshtehnejad Seyed-Mohammad, Simfroosh Naser, Basiri Abbas, Sharifian Mostafa, Hashemi Ghamar Hoseini, Falahzadeh Hosein, Derakhshan Ali, Fazel Mojtaba, Reiesee Darioush, Sayedzadeh Abdolhasan, Vazirian Shams, Nikibakhsh Ahmad Ali, Moghadam Ali Ghafari, Mohamadzadeh Hashem, Naderi Ali, Isfahani Taher, Larijani Faezeh, Shorkhi Hadi, Pasha Abazar Akbarzadeh, Shahbazian Heshmatollah, Valavi Ehsan, Mortazavi Fakhrolsadat, Gheisari Allaleh

机构信息

Urology and Nephrology Research Center, Shaheed Beheshti University of Medical Science, Labbafi Nejad Hospital, Ali Asghar Children's Hospital, Tehran, Iran.

出版信息

Pediatr Transplant. 2011 Aug;15(5):533-8. doi: 10.1111/j.1399-3046.2011.01507.x. Epub 2011 Apr 26.

Abstract

The outcome of pediatric renal transplantation was previously reported by a single-center study at the year 2006. Therefore, we aimed to evaluate and report the characteristics and outcome of renal pediatric renal transplantation in a multi-center nationwide study. In this nationwide report, medical records of 907 children (≤18yr) with renal transplantation in eight major pediatric transplant centers of Iran were recorded. These 907 patients received a total of 922 transplants. All children who failed to follow-up were excluded. Rather than baseline characteristics, graft and patient outcomes were considered for survival analysis. For further analysis, they were divided into two groups: patients who had graft survival time more than 10yr (n=91) and the ones with graft survival time of equal or less than 10yr (n=831). Of 922 recipients, 515 (55.8%) were boys and 407 (44.2%) were girls with the mean age of 13.10 (s.d.=3.54) yr. DGF and AR were occurred in 10% and 39.5% of the transplanted children, respectively. Transplantation year, dialyzing status before transplantation, DGF, and AR were significant enough to predict graft survival in cox regression model (overall model: p<0.001). Nowadays, there is a successful live donor pediatric renal transplantation in Iran. Graft survival has improved in our recipients and now the graft survival rates are near to international standards.

摘要

2006年,一项单中心研究曾报告过小儿肾移植的结果。因此,我们旨在通过一项全国性多中心研究来评估并报告小儿肾移植的特点及结果。在这份全国性报告中,记录了伊朗八大主要小儿移植中心907名(≤18岁)接受肾移植儿童的病历。这907名患者共接受了922次移植。所有未进行随访的儿童均被排除。生存分析考虑的不是基线特征,而是移植物和患者的结局。为进一步分析,将他们分为两组:移植物存活时间超过10年的患者(n = 91)和移植物存活时间等于或少于10年的患者(n = 831)。在922名受者中,515名(55.8%)为男孩,407名(44.2%)为女孩,平均年龄为13.10岁(标准差 = 3.54)。移植儿童中分别有10%和39.5%发生了移植肾功能延迟恢复(DGF)和急性排斥反应(AR)。在Cox回归模型中,移植年份、移植前透析状态、DGF和AR对预测移植物存活具有足够的显著性(总体模型:p<0.001)。如今,伊朗小儿活体肾移植取得了成功。我们的受者移植物存活率有所提高,现在已接近国际标准。

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