Yuan Qing, Zhang Lei, Wang Liming, Zeng Li, Zhou Meisheng, Zhu Youhua, Li Jindong, Chen Zhonghua
Department of Organ Transplantation, Changzheng Hospital, Shanghai, China.
Exp Clin Transplant. 2011 Jun;9(3):165-9.
We sought to evaluate the outcomes of a single kidney transplant from pediatric donors into adult recipients after controlled circulatory death.
A retrospective, single-center review of all adult recipients who received a single pediatric kidney from controlled-cardiac deceased-donors (aged, < 9 years old) between January 2006 and March 2008 was performed.
Eleven adult recipients (aged, 16-41 years) used single renal grafts from the controlled-cardiac deceased-donors (median donor age, 74 months; range, 49-106 months; median donor weight, 20.95 kg; range, 16.6-37.8 kg). The median recipient age was 27 years (range, 16-41 years; median recipient weight, 47 kg; range 39.5-53.6 kg). The patient's serum creatinine level gradually decreased, and the estimated glomerular filtration rate increased stably more than 2 times during follow-up. The graft length increased significantly the first week after transplant compared with that recorded immediately after reperfusion (P < .001) and grew slightly thereafter. Acute rejection occurred in 1 patient. Nine patients had high renal artery blood flow velocity index at 1 to 2 cm. Beside the anastomosis (167-321 cm/s), only 1 patient developed hypertension and slightly increased serum creatinine at 14 weeks after transplant. The 1-year patient/graft survival was 100%.
Use of single kidneys from pediatric donors after controlled cardiac death could expand the donor pool without compromising recipient outcomes.
我们试图评估在心脏死亡后将儿科供体的单个肾脏移植给成年受者的结果。
对2006年1月至2008年3月间所有接受来自心脏死亡供体（年龄<9岁）的单个儿科肾脏的成年受者进行了一项回顾性单中心研究。
11名成年受者（年龄16 - 41岁）使用了来自心脏死亡供体的单个肾移植（供体年龄中位数为74个月；范围49 - 106个月；供体体重中位数为20.95千克；范围16.6 - 37.8千克）。受者年龄中位数为27岁（范围16 - 41岁；受者体重中位数为47千克；范围39.5 - 53.6千克）。在随访期间，患者的血清肌酐水平逐渐下降，估计肾小球滤过率稳定增加超过2倍。移植后第一周移植物长度与再灌注后立即记录的长度相比显著增加（P < 0.001），此后略有增长。1例患者发生急性排斥反应。9例患者在距吻合口1至2厘米处肾动脉血流速度指数较高（167 - 321厘米/秒）。仅1例患者在移植后14周出现高血压且血清肌酐略有升高。患者/移植物1年生存率为100%。
在心脏死亡后使用儿科供体的单个肾脏可以扩大供体库，而不影响受者的预后。
