Urology, University Hospital of Nantes, Nantes, France.
Pediatric Urology Unit, University Hospital of Nantes, 1 place Alexis Ricordeau, Nantes, France.
World J Urol. 2021 Jul;39(7):2789-2794. doi: 10.1007/s00345-020-03537-w. Epub 2021 Jan 3.
The renal transplantation is the best treatment for end-stage renal disease in children. We present the findings of an analysis of our institution's paediatric transplant outcomes comparing recipients under 15 kg, who represent this potentially higher risk group, to those above 15 kg.
We retrospectively identified consecutive paediatric kidney transplants from a prospectively collected database for analysis. We included all recipients under the age of 18 years at the time of transplant between 2006 and 2018 without any exclusion criteria. The primary outcome was death-censored graft survival at 1 year, 5 years and 10 years.
109 paediatric kidney transplants were performed in 100 children. Graft survival in the all population was 98%, 96% and 76% at 1 year, 5 years and 10 years, respectively. Recipient weight below 15 kg was not found to be a risk factor of graft loss. Overall, we found no individual factor to be statistically significantly associated with renal graft lost. The overall complication rate was 16% (18/109) with 12 early complications (11%) and 6 late ones (5%).
Kidney transplantation in children weighing < 15 kg seems safe and offers the same patient and graft survival outcomes as in other (> 15 kg) pediatric recipients with equally low complication rates.
肾移植是儿童终末期肾病的最佳治疗方法。我们报告了对本机构儿科移植结果的分析,比较了体重<15kg 的受者(代表这一潜在高风险群体)与>15kg 的受者。
我们从一个前瞻性收集的数据库中回顾性地确定了连续的儿科肾移植,并进行了分析。我们纳入了 2006 年至 2018 年间所有年龄在 18 岁以下的受者,无任何排除标准。主要结局是 1 年、5 年和 10 年时的死亡风险校正移植物存活率。
在 100 例儿童中进行了 109 例儿科肾移植。所有患者的移植物存活率分别为 1 年时 98%、5 年时 96%和 10 年时 76%。<15kg 的受者体重并不是移植物丢失的危险因素。总体而言,我们没有发现任何单一因素与肾移植物丢失有统计学显著相关性。总的并发症发生率为 16%(18/109),其中 12 例为早期并发症(11%),6 例为晚期并发症(5%)。
体重<15kg 的儿童进行肾移植似乎是安全的,与其他(>15kg)儿科受者相比,可提供相同的患者和移植物存活率,且并发症发生率同样较低。