Kim Jin K, Lorenzo Armando J, Farhat Walid A, Chua Michael E, Ming Jessica M, Dos Santos Joana, Koyle Martin A
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Pediatr Transplant. 2019 May;23(3):e13377. doi: 10.1111/petr.13377. Epub 2019 Feb 8.
Little is known regarding post-transplant renal function following pediatric pre-emptive KT. Therefore, this study aims to determine whether there is a difference in 1 year post-transplant renal function outcomes between pre-emptive and post-dialysis KT in pediatric transplant recipients.
A retrospective review of patients who underwent kidney transplant at our institution between 2000 and 2015 was performed. Kidney transplant recipients were divided into four groups: pre-DD, post-DD, pre-LD, and post-LD. The clinical outcomes, measured in eGFR (mL/min/1.73 m ), acute rejection episodes within 1 year, and hospitalization within 1 year were compared to between groups in their respective donor types (pre-DD vs post-DD; pre-LD vs post-LD).
The 324 patients were identified (21 pre-DD, 151 post-DD, 54 pre-LD, and 98 post-LD). Post-DD group had more females (P = 0.018) and post-operative complications (P = 0.023), although there was no difference in complications requiring intervention (P = 0.129). Post-LD patients were more likely to be females (P = 0.017) and those with intrinsic renal (non-urological/structural) ESRD etiology (P = 0.003). The 1-year eGFR was similar between pre-DD and post-DD groups (70.3 [IQR 53.5-88.5] vs 74.3 [IQR 62.3-90.5], P = 0.613), as well as pre-LD and post-LD groups (66.6 [IQR 47.8-73.7] vs 63.9 [IQR 55.0-77.1], P = 0.600). There were no significant differences in rates of acute rejection episodes or hospitalization within 1 year of transplantation for in LD/DD groups.
There is no significant difference in renal function at 1 year post-transplant in pediatric patients receiving pre-emptive or post-dialysis kidney transplants.
关于小儿先发肾移植（KT）后的移植肾功能，人们了解甚少。因此，本研究旨在确定小儿移植受者先发KT和透析后KT在移植后1年肾功能结局方面是否存在差异。
对2000年至2015年间在本机构接受肾移植的患者进行回顾性研究。肾移植受者分为四组：透析前、透析后、移植前晚期、移植后晚期。比较了各组在各自供体类型（透析前与透析后；移植前晚期与移植后晚期）中以估算肾小球滤过率（eGFR，mL/min/1.73 m²）衡量的临床结局、1年内的急性排斥反应发作次数以及1年内的住院情况。
共确定了324例患者（21例透析前、151例透析后、54例移植前晚期、98例移植后晚期）。透析后组女性更多（P = 0.018）且术后并发症更多（P = 0.023），不过在需要干预的并发症方面无差异（P = 0.129）。移植后晚期患者更可能为女性（P = 0.017）且是患有内在性肾（非泌尿外科/结构性）终末期肾病病因的患者（P = 0.003）。透析前组和透析后组1年的eGFR相似（70.3[四分位间距53.5 - 88.5]对74.3[四分位间距62.3 - 90.5]，P = 0.613），移植前晚期组和移植后晚期组也是如此（66.6[四分位间距47.8 - 73.7]对63.9[四分位间距55.0 - 77.1]，P = 0.600）。在移植后1年内，移植前晚期/透析后组的急性排斥反应发作率或住院率无显著差异。
接受先发或透析后肾移植的小儿患者在移植后1年的肾功能无显著差异。
