Department of Neonatology and Pediatric Intensive Care Medicine, University Children's Hospital, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
Department of Visceral Transplant Surgery, University Medical Center Hamburg Eppendorf, Hamburg, Germany.
Pediatr Transplant. 2020 Nov;24(7):e13781. doi: 10.1111/petr.13781. Epub 2020 Aug 13.
IAH after RTX can threaten graft viability. This study aimed to assess the feasibility and safety of longitudinal IAP measurements as an IAH screening method in children after RTX. A cohort of eight children with a mean ± SD [range] age 9.6 ± 6.2 [2-17] years who underwent RTX and 18 control patients were evaluated between May 2017 and February 2018. We compared longitudinal IAP measurements using a Foley manometer to other clinical monitoring data. In total, 29 IAP measurements were performed in RTX patients and 121 in controls. The mean post-operative IAP was 7.4 ± 4.3 [1-16] mm Hg following RTX and 8.1 ± 3.7 [1-19] mm Hg in controls. We noted IAH in 9 (31%) of 29 IAP measurements after RTX and in 41 (34%) of 121 IAP measurements in controls. No graft dysfunction occurred in RTX patients despite elevated IAP values. The mean ± SD [range] time expenditure for IAP measurement was 2.1 ± 0.4 [0.6-3.2] minutes. No severe complications occurred during the IAP measurements. Analysis of longitudinal IAP measurements demonstrated that IAP measurement is safe and feasible in children recovering from renal transplantation in the PICU.
IAH 在 RTX 后可能会威胁移植物的存活。本研究旨在评估纵向 IAP 测量作为 RTX 后儿童 IAH 筛查方法的可行性和安全性。2017 年 5 月至 2018 年 2 月，我们评估了一组 8 名接受 RTX 治疗且平均年龄 ±标准差 [范围]为 9.6 ± 6.2 [2-17]岁的儿童和 18 名对照患者。我们比较了使用 Foley 测压计进行的纵向 IAP 测量与其他临床监测数据。总共对 RTX 患者进行了 29 次 IAP 测量，对对照组进行了 121 次 IAP 测量。RTX 后平均术后 IAP 为 7.4 ± 4.3 [1-16] mm Hg，对照组为 8.1 ± 3.7 [1-19] mm Hg。我们在 29 次 IAP 测量中有 9 次（31%）在 RTX 后出现 IAH，在 121 次 IAP 测量中有 41 次（34%）在对照组中出现 IAH。尽管 IAP 值升高，但 RTX 患者的移植物功能没有出现异常。IAP 测量的平均 ±标准差 [范围]时间消耗为 2.1 ± 0.4 [0.6-3.2]分钟。在 IAP 测量过程中未发生严重并发症。纵向 IAP 测量分析表明，在 PICU 中从肾移植中恢复的儿童中，IAP 测量是安全且可行的。
