Simforoosh Nasser, Zare Samad, Basiri Abbas, Tabibi Ali, Samzadeh Mohammad, Soltani Mohammad Hossein
From the Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Shahid Labbafinejad Medical Center, Tehran, Iran.
Exp Clin Transplant. 2014 Oct;12(5):391-5.
To evaluate outcomes and complications with pediatric living-donor kidney transplant, mostly performed with laparoscopic donor nephrectomy.
In the 25 years between February 1987 and December 2012, there were 493 children aged ≤ 17 years who received a kidney transplant. Demographic characteristics, graft and patient survival, rejection episodes, and complications were recorded. Analysis was performed for 3 sequential periods (1987-1994, 1995-2002, and 2003-2012).
The mean patient age was 13 ± 4 years (age range, 2.5-17 y). There were 290 males (59%). Glomerulonephritis was the most common cause of end-stage renal disease. Preemptive kidney transplant was performed in 412 patients (84%). Donor nephrectomy was performed laparoscopically in 445 patients (90%). The 5-year graft and patient survival were improved from 1987-1994 to 2003-2012. The overall death-censored graft survival was 96% at 1 year, 78% at 5 years, and 66% at 10 years after transplant. The overall patient survival was 96% at 1 year, 83% at 5 years, and 75% at 10 years after transplant.
Kidney transplant is available for most pediatric patients and has acceptable graft and patient survivals. Laparoscopic donor nephrectomy improves donor satisfaction and morbidity, and may provide excellent graft outcomes in children.
评估小儿活体供肾肾移植的结局及并发症，该手术大多采用腹腔镜供肾切除术。
在1987年2月至2012年12月的25年间，有493名17岁及以下儿童接受了肾移植。记录人口统计学特征、移植物和患者生存率、排斥反应发作情况及并发症。对三个连续时期（1987 - 1994年、1995 - 2002年和2003 - 2012年）进行分析。
患者平均年龄为13±4岁（年龄范围2.5 - 17岁）。男性290名（59%）。肾小球肾炎是终末期肾病最常见的病因。412名患者（84%）接受了择期肾移植。445名患者（90%）采用腹腔镜进行供肾切除术。从1987 - 1994年到2003 - 2012年，5年移植物和患者生存率有所提高。移植后1年总体死亡截尾移植物生存率为96%，5年为78%，10年为66%。移植后1年总体患者生存率为96%，5年为83%，10年为75%。
大多数小儿患者可进行肾移植，移植物和患者生存率可接受。腹腔镜供肾切除术提高了供者满意度并降低了发病率，且可能为儿童提供良好的移植物结局。
