Almardini Reham Issa, Salita Ghazi Mohamad, Farah Mahdi Qasem, Katatbeh Issa Ahmad, Al-Rabadi Katibh
Queen Rania Abdulla Children's Hospital, Amman Jordan.
Exp Clin Transplant. 2017 Feb;15(Suppl 1):99-103. doi: 10.6002/ect.mesot2016.O95.
Kidney transplant is the treatment of choice for end-stage renal disease, but it is not without complications. We review the medical cause of significant renal impairment and complications that developed after kidney transplant in pediatric patients who required hospital admission and intervention and/or who were followed between 2007 and 2016.
A retrospective noninterventional chart review study was conducted in pediatric patients who received a kidney transplant and/or followed at the nephrology clinic at Queen Rania Abdulla Children's Hospital between 2007 and 2016.
In this study, 101 pediatric patients received a total of 103 transplants. Forty-eight patients (47%) experienced deterioration of kidney function out of a total of 53 episodes of complications; 37 of these episodes occurred early (0-6 mo after transplant), and 26 episodes occurred late. The causes of kidney function deterioration were surgical complications, acute tubular necrosis, cell- or antibody-mediated rejection, diabetes mellitus, urinary leak, recurrence of original disease, and chronic allograft nephropathy. Thirteen patients experienced graft loss; 50% of these losses were secondary to noncompliance to immunosuppressant medication treatment after transplant. A total of six patients died; 2 (23%) of these deaths occurred in the first week after transplant, whereas the other 4 patients died over a period of 10 years.
Pediatric kidney transplant is not without complications; however, most of these complications are treatable and reversible. The most serious complications leading to graft loss and death occur early, in the first week after transplant. Improving immunosuppressant compliance after transplant would prevent 50% of graft losses.
肾移植是终末期肾病的首选治疗方法，但并非没有并发症。我们回顾了2007年至2016年间需要住院治疗和干预及/或接受随访的儿科肾移植患者出现严重肾功能损害及并发症的医学原因。
对2007年至2016年间在阿卜杜拉王后儿童医院肾病科接受肾移植和/或接受随访的儿科患者进行了一项回顾性非干预性病历审查研究。
在本研究中，101名儿科患者共接受了103次移植。在总共53次并发症中，48名患者（47%）出现了肾功能恶化；其中37次并发症发生在早期（移植后0 - 6个月），26次发生在晚期。肾功能恶化的原因包括手术并发症、急性肾小管坏死、细胞或抗体介导的排斥反应、糖尿病、尿漏、原发病复发和慢性移植肾肾病。13名患者移植肾丢失；其中50%的丢失是由于移植后未遵医嘱服用免疫抑制剂治疗所致。共有6名患者死亡；其中2例（23%）在移植后第一周死亡，另外4例患者在10年期间死亡。
儿科肾移植并非没有并发症；然而，这些并发症大多是可治疗和可逆的。导致移植肾丢失和死亡的最严重并发症发生在早期，即移植后第一周。提高移植后免疫抑制剂的依从性可预防50%的移植肾丢失。
