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马凡综合征终末期肾病的成功肾移植

Successful Kidney Transplantation for End-Stage Renal Disease in Marfan's Syndrome.

作者信息

Ryosaka Makoto, Omoto Kazuya, Nozaki Taiji, Yoshida Kazuhiko, Sawada Yugo, Hirano Hajime, Shimizu Tomokazu, Ishida Hideki, Tanabe Kazunari

机构信息

Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.

出版信息

Case Rep Transplant. 2013;2013:809613. doi: 10.1155/2013/809613. Epub 2013 Sep 4.

Abstract

Marfan's syndrome is a systemic disorder of the connective tissue caused by mutations in the extracellular matrix protein fibrillin-1, with aortic dissection and aneurysm being its most life-threatening manifestations. Kidney transplantation for end-stage renal disease (ESRD) in patients with Marfan's syndrome has not been reported in the literature, and the rate of the incidence of dissection or aneurysm in the iliac artery is unknown. Here, we present a patient with Marfan's syndrome with ESRD due to severe renal ischemia caused by massive bleeding from thoracoabdominal aortic dissection leading to transplant surgery of a living kidney procured from the patient's mother. After kidney transplantation, the renal function normalized without vascular complications, and stable graft function along with negative results for both microhematuria and proteinuria continued for two years. Also, vascular complication such as aneurysm or dissection of the iliac artery was not observed using ultrasonography during the follow-up period. ESRD patients with Marfan's syndrome might be suitable for kidney transplantation, but long-term and careful observations are needed.

摘要

马凡综合征是一种由细胞外基质蛋白原纤蛋白-1突变引起的结缔组织全身性疾病,主动脉夹层和动脉瘤是其最危及生命的表现。文献中尚未报道马凡综合征患者因终末期肾病(ESRD)进行肾移植的情况,髂动脉夹层或动脉瘤的发生率也未知。在此,我们报告一名患有马凡综合征和ESRD的患者,其病因是胸腹主动脉夹层大量出血导致严重肾缺血,进而接受了来自患者母亲的活体肾移植手术。肾移植后,肾功能恢复正常,未出现血管并发症,移植肾功能稳定,镜下血尿和蛋白尿均为阴性,持续了两年。此外,在随访期间通过超声检查未观察到髂动脉动脉瘤或夹层等血管并发症。患有马凡综合征的ESRD患者可能适合肾移植,但需要长期且仔细的观察。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/36a5/3777197/81a58e504157/CRIM.TRANSPLANTATION2013-809613.001.jpg

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