复杂的开放性手术并不会增加小儿肾移植术后血管并发症的风险。

Complex Bench Surgery Does Not Increase the Risk of Vascular Complications after Pediatric Kidney Transplantation.

作者信息

Ghidini Filippo, Fascetti Leon Francesco, De Corti Federica, Meneghesso Davide, Longo Germana, Sgrò Alberto, Michelon Stefania, Metrangolo Salvatore, Meneghini Luisa, Castagnetti Marco, Benetti Elisa, Gamba Piergiorgio, Dall'Igna Patrizia

机构信息

Department of Women's and Children's Health, Pediatric Surgery Unit, University of Padua, Padova, Veneto, Italy.

Department of Pediatric Surgery, Women and Children Health, Padova, Italy.

出版信息

Eur J Pediatr Surg. 2023 Apr;33(2):167-173. doi: 10.1055/s-0042-1751046. Epub 2022 Jul 19.

DOI:10.1055/s-0042-1751046

PMID:35853468

Abstract

INTRODUCTION

Vascular complications are severe complications of pediatric kidney transplantation (KT). We aimed to investigate whether a complex bench surgery (BS) affects the outcomes.

METHODS

All pediatric KT performed at the University Hospital of Padua from 2015 to 2019 were analyzed, comparing those in which a standard BS was possible to those that necessitated a complex BS. The rates of vascular complications, patients' outcome, and graft survival were compared in the two groups.

RESULTS

Eighty KTs were performed in 78 patients with a median age of 11 years (interquartile range [IQR] 4.3-14) and a median body weight of 24 kg (IQR 13-37). Thirty-nine donor kidneys (49%) needed a complex BS due to anomalies of renal veins in 12 (31%) and renal arteries in 16 (41%). The remaining 11 grafts (28%) underwent an elongation of the vein. There was no difference in the rate of primary graft non function ( = 0.97), delayed graft function ( = 0.72), and overall survival ( = 0.27). The rates of vascular complications, bleedings, and venous graft thrombosis were similar ( = 0.51, = 0.59, = 0.78, respectively). No arterial thrombosis or stenosis was reported.

CONCLUSION

Complex BS did not compromise survival of the graft and did not put the allograft at risk of vascular complications, such as bleedings or thrombosis.

摘要

引言

血管并发症是小儿肾移植（KT）的严重并发症。我们旨在研究复杂的台式手术（BS）是否会影响手术结果。

方法

对2015年至2019年在帕多瓦大学医院进行的所有小儿肾移植手术进行分析，比较那些可行标准台式手术的病例与那些需要复杂台式手术的病例。比较两组的血管并发症发生率、患者预后和移植物存活率。

结果

78例患者共进行了80例肾移植手术，患者中位年龄为11岁（四分位间距[IQR]4.3 - 14），中位体重为24 kg（IQR 13 - 37）。39个供肾（49%）因肾静脉异常（12个，31%）和肾动脉异常（16个，41%）需要进行复杂的台式手术。其余11个移植物（28%）进行了静脉延长。原发性移植物无功能发生率（= 0.97）、移植肾功能延迟发生率（= 0.72）和总体存活率（= 0.27）无差异。血管并发症、出血和静脉移植物血栓形成的发生率相似（分别为= 0.51、= 0.59、= 0.78）。未报告动脉血栓形成或狭窄。