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儿童局灶节段性肾小球硬化患者肾移植的长期随访结果:单中心经验

Long-Term Follow-up Results of Renal Transplantation in Pediatric Patients With Focal Segmental Glomerulosclerosis: A Single-Center Experience.

作者信息

Bulut I K, Taner S, Keskinoglu A, Toz H, Sarsik B, Sezer T O, Kabasakal C

机构信息

Department of Pediatric Nephrology, Ege University Faculty of Medicine, İzmir, Turkey.

Department of Pediatric Nephrology, Ege University Faculty of Medicine, İzmir, Turkey.

出版信息

Transplant Proc. 2019 May;51(4):1064-1069. doi: 10.1016/j.transproceed.2019.01.096. Epub 2019 Feb 8.

Abstract

INTRODUCTION AND AIM

Focal segmental glomerulosclerosis (FSGS) is a common cause of end-stage renal disease in children. We analyzed the long-term outcome of pediatric patients with FSGS undergoing renal transplantation. The objective of the study is to report the experience of a single center and determine the incidence of recurrence, rejection, graft loss, and related risk factors.

MATERIALS AND METHOD

This retrospective cohort study was performed between 1991 and 2018. Thirty patients with a pathologic diagnosis of primary FSGS were included in the study. The patients were diagnosed with FSGS according to histologic features in biopsies.

RESULTS

Twenty-one of the donors were deceased (70%) and 9 were alive (30%). FSGS recurred in only 2 patients. Graft loss occurred in 6 patients (20%). The causes of graft loss were chronic rejection in 4 patients and acute rejection in 2. Our graft survival rate was 100% at 1 year, 91% at 5 years, 80% at 10 years, 70% at 15 years, and 42% at 20 years. Five- and 10-year graft survival rates were 83% and 83% in living donors and 94% and 79% in deceased donors, respectively. According to Kaplan-Meier analysis, there was no statistically significant difference in terms of graft survival between living and deceased donors.

CONCLUSION

This study, with its contribution to literature in terms of long follow-up of FSGS patients from childhood to adulthood, is important. However, further studies are required.

摘要

引言与目的

局灶节段性肾小球硬化(FSGS)是儿童终末期肾病的常见病因。我们分析了接受肾移植的FSGS患儿的长期预后。本研究的目的是报告单一中心的经验,并确定复发、排斥反应、移植肾丢失及相关危险因素的发生率。

材料与方法

本回顾性队列研究于1991年至2018年进行。纳入30例经病理诊断为原发性FSGS的患者。患者根据活检的组织学特征诊断为FSGS。

结果

供者中21例已死亡(70%),9例存活(30%)。仅2例患者出现FSGS复发。6例患者(20%)发生移植肾丢失。移植肾丢失的原因是4例慢性排斥反应和2例急性排斥反应。我们的移植肾1年存活率为100%,5年为91%,10年为80%,15年为70%,20年为42%。活体供者的5年和10年移植肾存活率分别为83%和83%,尸体供者分别为94%和79%。根据Kaplan-Meier分析,活体供者和尸体供者在移植肾存活方面无统计学显著差异。

结论

本研究对FSGS患者从儿童到成人的长期随访资料丰富了文献,具有重要意义。然而,仍需要进一步研究。

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