From the Department of Pediatric Nephrology, Iran University of Medical Sciences. Tehran, Iran.
Exp Clin Transplant. 2022 Oct;20(10):895-900. doi: 10.6002/ect.2020.0274. Epub 2021 Apr 29.
End-stage kidney disease has dramatic health effects and life consequences in children. Presently, kidney transplant has been globally accepted as a treatment of choice for end-stage kidney disease in both children and adults, leading to better quality of life and longer patient survival. Because of lack of comprehensive information on the outcome of kidney transplant among children in Iran, we aimed to present a proper vision of pediatric kidney transplant in Iran by systematically reviewing the current literature.
Major databases were searched, including Medline, Web of Knowledge, Google Scholar, Scopus, Cochrane, and the Iranian Scientific Information Database for all eligible studies in accordance with specific keywords. The inclusion criteria forthe retrieved studies were determination of graft survival, patient survival, and reasons for graft failure. The exclusion criteria were as follows: (1) a lack of clearresults; (2) non-English or non-Persian language format; (3) lack of access to the full-text manuscripts; and (4) case reports, case series, and review papers. A total of 115 studies were initially assessed based on the keywords; of these, 8 met inclusion criteria and were considered for final analysis; these were published between 2005 and 2017.
According to our results, 1-year graft survival rates were overall 89.7%, and 5-year graft survival rates were 65.4%. The 1-year patient survival rates were estimated to be 97.1%, and 5-year patient survival rates were estimated to be 89.8%. Acute rejection, dialysis status before transplant, and inappropriate immunosuppression were the main risk factors.
Our systematic review and meta-analysis indicated a high success rate of childhood kidney transplant in Iran according to long-term graft and patient survival rates.
终末期肾病会对儿童的健康和生活产生巨大影响。目前，肾移植已在全球范围内被接受为儿童和成人终末期肾病的首选治疗方法，可提高生活质量并延长患者的生存时间。由于伊朗缺乏儿童肾移植结果的综合信息，我们旨在通过系统综述当前文献，对伊朗儿科肾移植提供一个恰当的视角。
根据特定的关键词，在主要数据库（包括 Medline、Web of Knowledge、Google Scholar、Scopus、Cochrane 和伊朗科学信息数据库）中搜索所有符合条件的研究。纳入研究的标准为确定移植物存活率、患者存活率和移植物衰竭的原因。排除标准如下：（1）结果不明确；（2）非英语或波斯语格式；（3）无法获取全文手稿；（4）病例报告、病例系列和综述论文。根据关键词，最初评估了 115 项研究；其中 8 项符合纳入标准并进行了最终分析；这些研究发表于 2005 年至 2017 年之间。
根据我们的结果，1 年移植物存活率总体为 89.7%，5 年移植物存活率为 65.4%。1 年患者存活率估计为 97.1%，5 年患者存活率估计为 89.8%。急性排斥反应、移植前透析状态和不适当的免疫抑制是主要的风险因素。
我们的系统综述和荟萃分析表明，伊朗儿童肾移植的成功率很高，根据长期移植物和患者存活率。
