婴儿（<2 岁）肾移植的改善结局：单中心经验。

Improved Outcomes of Kidney Transplantation in Infants (Age < 2 years): A Single-Center Experience.

机构信息

Division of Pediatric Nephrology, University of Minnesota, Minneapolis, MN.

Department of Surgery, University of Minnesota, Minneapolis, MN.

出版信息

Transplantation. 2018 Feb;102(2):284-290. doi: 10.1097/TP.0000000000001929.

DOI:10.1097/TP.0000000000001929

PMID:28846558

Abstract

BACKGROUND

Infants (age, < 2 years) with end-stage renal disease (ESRD) have increased morbidity and mortality. We evaluated our long-term outcomes of kidney transplants (KTx) in infants.

METHODS

Between 1984 and 2014, 136 infants underwent KTx. We examined trends in survival rates and complications by era (1984-1993 [era 1], 1994-2003 [era 2], 2004-2014 [era 3]).

RESULTS

Patients were 92.6% white and 70.6% males. Posttransplant (Tx) initial length of hospital stay declined 37% over the 30-year period (P <0.01). Ten-year death-censored graft survival improved from 60% (era 1) to 80% (era 2) (P = 0.04). The incidence of acute rejection, graft thrombosis, cytomegalovirus, and urine leaks did not significantly change across eras. Frequency of Epstein-Barr virus diagnosis (era 2 vs era 3, P < 0.01) increased. Post-Tx lymphoproliferative disorder incidence was increased in era 2 compared with eras 1 and 3 (P = 0.03).

CONCLUSIONS

Infants deserve earlier consideration for KTx. Length of initial hospital stay and patient and graft survival rates after KTx have improved in infants since 1984.

摘要

背景

患有终末期肾病（ESRD）的婴儿（年龄<2 岁）发病率和死亡率较高。我们评估了婴儿肾移植（KTx）的长期结果。

方法

1984 年至 2014 年间，136 名婴儿接受了 KTx。我们通过时代（1984-1993 年[时代 1]、1994-2003 年[时代 2]、2004-2014 年[时代 3]）检查了生存率和并发症的趋势。

结果

患者 92.6%为白人，70.6%为男性。移植后（Tx）的初始住院时间在 30 年内下降了 37%（P<0.01）。10 年无死亡原因的移植物存活率从 60%（时代 1）提高到 80%（时代 2）（P=0.04）。急性排斥反应、移植物血栓形成、巨细胞病毒和尿液漏出的发生率在不同时代没有显著变化。EB 病毒诊断的频率（时代 2 与时代 3，P<0.01）增加。与时代 1 和 3 相比，时代 2 的移植后淋巴增殖性疾病发生率增加（P=0.03）。