Okut Gökalp, Doğan Güleç Mert, Doğan Sait Murat
Department of Gastrointestinal Surgery, Inonu University Faculty of Medicine, Malatya, Turkey.
Clinic of Pediatric Radiology, Malatya Research and Training Hospital, Malatya, Turkey.
Turk J Surg. 2021 Dec 31;37(4):313-317. doi: 10.47717/turkjsurg.2021.5319. eCollection 2021 Dec.
Although renal transplantation (RT) is the first treatment option for children with end-stage renal failure, the number of transplanted chil- dren remains low compared to adults. Experience of the individual pediatric transplant center is very important in the prognosis of pediatric transplant recipients. In this study, our pediatric RT experience was presented.
We retrospectively analyzed the data of 27 patients who had RT in our clinic between April 2009 and April 2019.
Fifteen of the patients were males, and mean age of all patients was 12.36 ± 4.18 years (range 4-17 years). The most frequent etiology for end- stage renal disease (ESRD) was vesicourethral reflux. Eighteen (66.7%) of the transplanted kidneys came from cadaveric donors and 9 (33.3%) from live donors. One patient had preemptive RT and one patient had a re-RT. Twenty-two patients were on peritoneal dialysis program and four patients were on hemodialysis program. Mean dialysis time before transplantation was 29 (3-104) months. Bleeding was the most common surgical complication. Delayed graft function developed in four patients, and all of their grafts were from cadaveric donors. Rejection developed in 12 of our patients, graft loss was observed in only four of them. Considering all patients, graft survival rates were 100% in the 1st and 3rd years, and 92% in the 5th year.
Pediatric RT program is difficult to establish, maintain and develop. Complications after transplantation are not uncommon; therefore, early detection and appropriate management are needed. Strategies are still needed to increase post-transplant success.
尽管肾移植（RT）是终末期肾衰竭儿童的首选治疗方案，但与成人相比，接受移植的儿童数量仍然较少。个体儿科移植中心的经验对儿科移植受者的预后非常重要。在本研究中，我们介绍了我们的儿科肾移植经验。
我们回顾性分析了2009年4月至2019年4月期间在我们诊所接受肾移植的27例患者的数据。
15例患者为男性，所有患者的平均年龄为12.36±4.18岁（范围4 - 17岁）。终末期肾病（ESRD）最常见的病因是膀胱输尿管反流。18个（66.7%）移植肾来自尸体供体，9个（33.3%）来自活体供体。1例患者进行了先发制人肾移植，1例患者进行了再次肾移植。22例患者接受腹膜透析治疗，4例患者接受血液透析治疗。移植前的平均透析时间为29（3 - 104）个月。出血是最常见的手术并发症。4例患者出现移植肾功能延迟恢复，且他们所有的移植物均来自尸体供体。12例患者发生排斥反应，其中仅4例观察到移植物丢失。考虑所有患者，第1年和第3年的移植物存活率为100%，第5年为92%。
儿科肾移植项目难以建立、维持和发展。移植后并发症并不罕见；因此，需要早期发现和适当管理。仍需要采取策略来提高移植后的成功率。
