Barbouch Samia, Hajji Meriam, Hedri Hafedh, El Younsi Fethi, Ben Hamida Fathi, Bacha Mohammed Mongi, Ounissi Mondher, Abderrahim Ezzedine, Ben Abdallah Taieb
Department of Nephrology, Charles Nicolle Hospital, Tunis, Tunisia.
Exp Clin Transplant. 2017 Feb;15(Suppl 1):196-199. doi: 10.6002/ect.mesot2016.P78.
Autosomal dominant polycystic kidney disease is a common cause of end-stage renal disease and a common indication for renal transplant. This study was undertaken to evaluate the demographics, outcomes, and complications of renal transplant in patients with autosomal dominant polycystic kidney disease compared with other nephropathies.
In a retrospective case-control design, we reviewed the records of 7 patients with autosomal dominant polycystic kidney disease from a total of 701 renal transplant patients over a 30-year period (1986-2016). For each patient, a matched control was selected based on sex, age, year of transplant, and type of kidney donor. We excluded patients who underwent kidney transplant abroad and those with a follow-up period of less than 2 years.
The number of patients with autosomal dominant polycystic kidney disease requiring transplant at our center was estimated at 0.23 per year, and the condition represented 1.57% of initial nephropathy causes. The mean patient age at transplant was 50.8 ± 8.05 years. There were 5 male and 2 female patients in the case group, with a male-to-female ratio of 2.5. The source of the graft was predominantly a living related donor (5/7). Four patients had extrarenal manifestations, the most common of which were liver cysts (3 patients). Rejection occurred in a single study patient (14.2%) and in 4 control patients (57.1%; P = .51). Two patients did not develop any complications. Complications noted after transplant included infection (3/7 cases vs 2/7 controls; P= .67) and cerebrovascular accidents (2/7 cases vs 0/7 controls).
Further studies with longer follow-up and greater numbers of patients are needed to compare more precisely the complications and results of transplant between patients with autosomal dominant polycystic kidney disease and other kidney transplant recipients.
常染色体显性遗传性多囊肾病是终末期肾病的常见病因，也是肾移植的常见指征。本研究旨在评估常染色体显性遗传性多囊肾病患者肾移植的人口统计学特征、结局及并发症，并与其他肾病患者进行比较。
采用回顾性病例对照设计，我们回顾了30年间（1986 - 2016年）701例肾移植患者中7例常染色体显性遗传性多囊肾病患者的记录。对于每例患者，根据性别、年龄、移植年份和肾脏供体类型选择匹配的对照。我们排除了在国外接受肾移植的患者以及随访期少于2年的患者。
据估计，我们中心每年需要移植的常染色体显性遗传性多囊肾病患者数量为0.23例，该疾病占初始肾病病因的1.57%。移植时患者的平均年龄为50.8±8.05岁。病例组有5例男性和2例女性患者，男女比例为2.5。移植物来源主要是活体亲属供体（5/7）。4例患者有肾外表现，最常见的是肝囊肿（3例）。1例研究患者（14.2%）和4例对照患者（57.1%）发生排斥反应（P = 0.51）。2例患者未出现任何并发症。移植后出现的并发症包括感染（3/7例 vs 2/7例对照；P = 0.67）和脑血管意外（2/7例 vs 0/7例对照）。
需要进行更长随访期和更多患者的进一步研究，以更精确地比较常染色体显性遗传性多囊肾病患者与其他肾移植受者之间移植的并发症和结果。
