Vitola S P, Gnatta D, Garcia V D, Garcia C D, Bittencourt V B, Keitel E, Pires F S, D'Avila A R, Silva J G, Amaral R L, Santos L N, Kruel C D P
Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Cirúrgicas, Porto Alegre, Brazil.
Pediatr Transplant. 2013 Aug;17(5):445-53. doi: 10.1111/petr.12104. Epub 2013 Jun 4.
Small children are a challenging group in whom to perform KT. This retrospective study analyzed the results of 62 KTs in children weighing <15 kg, performed between 1998 and 2010, using extraperitoneal access and anastomosis of the renal vessels of donors to the aorta and IVC or iliac vessels of the recipients. Thirty-two (51.6%) grafts were LRDTs and 30 (48.4%) were DDRTs-28 of them pediatric. The mean age at KT was 3.7 ± 2.2 yr (1-12), and the mean weight was 12.3 ± 2.1 kg (5.6-14.9). Ten children weighed <10 kg, and five (8.1%) children presented previous thrombosis of the venous system. At one and five yr, patient survival was 93.2% and 84.2%, and graft survival was 85.2% and 72.7%. There were no differences between the rates for LRDT and DDRT. There were six vascular complications (four vascular thromboses, one laceration, and one renal artery stenosis) and two perirenal collections. Extraperitoneal access is a valid KT technique in children weighing <15 kg.
对小儿进行肾移植是一个具有挑战性的群体。这项回顾性研究分析了1998年至2010年间对62例体重<15kg的儿童进行肾移植的结果，采用腹膜外入路，并将供体肾血管与受体的主动脉、下腔静脉或髂血管进行吻合。32例（51.6%）移植物为活体亲属供肾移植（LRDT），30例（48.4%）为尸体供肾移植（DDRT），其中28例为小儿供肾。肾移植时的平均年龄为3.7±2.2岁（1 - 12岁），平均体重为12.3±2.1kg（5.6 - 14.9kg）。10例儿童体重<10kg，5例（8.1%）儿童既往有静脉系统血栓形成。1年和5年时，患者生存率分别为93.2%和84.2%，移植物生存率分别为85.2%和72.7%。LRDT和DDRT的生存率无差异。有6例血管并发症（4例血管血栓形成、1例撕裂伤和1例肾动脉狭窄）和2例肾周积液。腹膜外入路是对体重<15kg儿童进行肾移植的一种有效技术。
