Afanetti Mickael, Niaudet Patrick, Niel Olivier, Saint Faust Marie, Cochat Pierre, Berard Etienne
Department of Pediatric Nephrology, Hôpitaux pédiatriques de Nice CHU-Lenval et Université de Nice - Sophia-Antipolis, Nice, France.
Pediatr Transplant. 2012 Mar;16(2):183-6. doi: 10.1111/j.1399-3046.2012.01654.x.
Chronic shortage of available donor organs has led to re-evaluation of the use of en bloc kidney transplants. Although excellent results have been reported in adult patients, experience in pediatric patients remains limited because of potential early complications and poor long-term graft outcome. We report 14 pediatric en bloc renal transplantations into 14 pediatric recipients, performed between 1990 and 2007 in France. We retrospectively analyzed demographic data, postoperative complications, and graft function with a median follow-up of five yr. Donor age ranged from four to 54 months. Complications were vascular graft thrombosis in four patients, leading to graft loss in two cases, and to excellent long-term graft function in the two others. Two hemorrhagic complications resulted in death in one case and in graft loss in the other. Six acute rejection episodes occurred in four patients. Median glomerular filtration rate at three months, one, five, and 10 yr was 90.8, 106, 87.8, and 66.1 mL/1.73 m(2) /min. We believe that en bloc transplantation may be an option for children with end-stage kidney disease.
可用供体器官的长期短缺促使人们重新评估整块肾移植的应用。尽管已有报道称成年患者的整块肾移植效果良好，但由于潜在的早期并发症和较差的长期移植结局，小儿患者的相关经验仍然有限。我们报告了1990年至2007年期间在法国为14名小儿受者进行的14例整块肾移植手术。我们回顾性分析了人口统计学数据、术后并发症及移植肾功能，中位随访时间为5年。供体年龄在4至54个月之间。并发症包括4例患者发生血管移植血栓形成，其中2例导致移植肾丢失，另2例移植肾长期功能良好。2例出血并发症，1例导致死亡，另1例导致移植肾丢失。4例患者发生6次急性排斥反应。术后3个月、1年、5年和10年的中位肾小球滤过率分别为90.8、106、87.8和66.1 mL/1.73 m²/min。我们认为，整块肾移植可能是终末期肾病患儿的一种选择。
