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泌尿系统异常患儿的肾移植

Pediatric Kidney Transplantation in Patients With Urologic Anomalies.

作者信息

Bulut Ipek Kaplan, Taner Sevgin, Keskinoglu Ahmet, Sezer Taylan Ozgur, Kabasakal Caner

机构信息

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

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

出版信息

Transplant Proc. 2019 Sep;51(7):2257-2261. doi: 10.1016/j.transproceed.2019.01.155. Epub 2019 Aug 7.

DOI:10.1016/j.transproceed.2019.01.155
PMID:31400969
Abstract

INTRODUCTION

and Aim. End-stage renal disease owing to structural urologic anomalies is frequent in the pediatric population. Impaired bladder function is thought to have a negative effect on graft function and survival. The aim of this study was to present our single-center experience and long-term follow-up results in pediatric patients who underwent renal transplantation for urologic reasons and to compare graft survival among patients who underwent transplantation for nonurologic reasons.

METHOD

The paper records of renal transplanted children (<18 years of age) held by Ege University Medical Faculty between 1998 and 2018 were evaluated retrospectively. Patients with normal bladder function who underwent transplantation for urologic reasons were defined as group A, whereas patients who had impaired bladder function and underwent transplantation for urologic reasons were defined as group B; a control group was defined as group C.

RESULTS

Eighty-three patients were included in the study. The creatinine values of the patients at their last visit were no different between groups (P = .930). One-, 5-, and 10-year graft survival rates were 97%, 89%, and 74%, respectively, in group A; 100% for all years in group B; and 97%, 94%, and 80%, respectively, in group C. There was no statistically significant difference in terms of graft survival between groups (P = .351).

CONCLUSION

Children with end-stage renal disease owing to urologic abnormalities may be good candidates for kidney transplantation with a favorable prognosis for graft function and survival.

摘要

引言与目的。因泌尿系统结构异常导致的终末期肾病在儿科人群中很常见。膀胱功能受损被认为会对移植肾功能和存活产生负面影响。本研究的目的是介绍我们单中心对因泌尿系统原因接受肾移植的儿科患者的经验和长期随访结果,并比较因非泌尿系统原因接受移植的患者的移植物存活率。

方法

回顾性评估了1998年至2018年间伊兹密尔埃杰大学医学院保存的肾移植儿童(<18岁)的病历记录。因泌尿系统原因接受移植且膀胱功能正常的患者被定义为A组,而因泌尿系统原因接受移植且膀胱功能受损的患者被定义为B组;对照组被定义为C组。

结果

83例患者纳入研究。各组患者最后一次就诊时的肌酐值无差异(P = 0.930)。A组1年、5年和10年的移植物存活率分别为97%、89%和74%;B组各年份均为100%;C组分别为97%、94%和80%。各组间移植物存活率无统计学显著差异(P = 0.351)。

结论

因泌尿系统异常导致终末期肾病的儿童可能是肾移植的良好候选者,移植物功能和存活预后良好。

相似文献

1
Pediatric Kidney Transplantation in Patients With Urologic Anomalies.泌尿系统异常患儿的肾移植
Transplant Proc. 2019 Sep;51(7):2257-2261. doi: 10.1016/j.transproceed.2019.01.155. Epub 2019 Aug 7.
2
Pediatric renal transplantation and the dysfunctional bladder.小儿肾移植与功能障碍性膀胱
Transpl Int. 2004 Nov;17(10):596-602. doi: 10.1007/s00147-004-0784-6. Epub 2004 Oct 29.
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Should a complex uropathy be a contraindication for renal transplantation in children?复杂性泌尿系统疾病是否应作为儿童肾移植的禁忌证?
Transplant Proc. 2010 Jul-Aug;42(6):2365-8. doi: 10.1016/j.transproceed.2010.05.004.
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Pediatric Kidney Transplantation Outcomes in Children with Primary Urological Abnormalities Versus Nonurological Abnormalities: Long-Term Results.小儿原发性泌尿系统异常与非泌尿系统异常患儿肾移植的长期结局比较。
J Urol. 2020 Feb;203(2):406-412. doi: 10.1097/JU.0000000000000528. Epub 2019 Sep 5.
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Renal Transplant in the Abnormal Bladder: Long-Term Follow-Up.异常膀胱中的肾移植:长期随访
Exp Clin Transplant. 2018 Feb;16(1):10-15. doi: 10.6002/ect.2016.0193. Epub 2017 Jul 31.
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Renal transplantation in children with abnormal lower urinary tract.
Transplant Proc. 2004 Dec;36(10):2968-73. doi: 10.1016/j.transproceed.2004.11.095.
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Kidney transplantation in children with bladder augmentation or ileal conduit diversion.接受膀胱扩大术或回肠代膀胱术的儿童肾移植。
Eur J Pediatr Surg. 2010 Jan;20(1):5-10. doi: 10.1055/s-0029-1234114. Epub 2009 Oct 28.
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Outcome of renal transplant in patients with abnormal urinary tract.
Pediatr Surg Int. 2011 Apr;27(4):423-30. doi: 10.1007/s00383-010-2704-4. Epub 2010 Aug 31.
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How does the presence of urologic problems change the outcome of kidney transplantation in the pediatric age group.泌尿系统问题的存在如何改变儿童年龄组肾移植的结果?
Transplant Proc. 2006 Mar;38(2):552-3. doi: 10.1016/j.transproceed.2005.12.101.
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Does renal transplant in children with LUTD improve their bladder function?儿童尿路疾病行肾移植是否能改善膀胱功能?
Pediatr Transplant. 2020 Sep;24(6):e13735. doi: 10.1111/petr.13735. Epub 2020 May 30.

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Clean Intermittent Catheterization in Children under 12 Years Does Not Have a Negative Impact on Long-Term Graft Survival following Pediatric Kidney Transplantation.12岁以下儿童的清洁间歇性导尿对小儿肾移植后的长期移植物存活没有负面影响。
J Clin Med. 2023 Dec 20;13(1):33. doi: 10.3390/jcm13010033.