Gellert S, Devaux S, Schönberger B, May G
Department of Pediatric Nephrology, Charité, Humboldt University, Berlin, Germany.
Pediatr Nephrol. 1996 Dec;10(6):716-9. doi: 10.1007/s004670050197.
We evaluated survival and renal function of cadaveric donor grafts according to donor age. The median age of the pediatric donors was 7.0 (0.7-16) years in 46 patients [median age 11.8 years (range) 3-16.8 years]. The median age of the adult donors was 34.4 (19-54) years in 59 patients [median age 12.1 years (range) 7-17.3 years]. Thirty patients were treated with azathioprine and prednisolone and 75 with cyclosporine A and prednisolone. The glomerular filtration rate (GFR) and the effective renal plasma flow (ERPF) were determined by the clearances of 51chromium-EDTA and 125iodine-hippurate 1-48 months after kidney transplantation. There was no difference in graft survival between pediatric and adult grafts. There were also no differences in GFR in patients receiving grafts from pediatric or adult donors; 2-3 months after transplantation the GFR in recipients of pediatric grafts was 62 +/- 20 ml/min per 1.73 m2 compared with 61 +/- 21 in those receiving adult grafts. The ERPF in recipients of adult grafts was significantly higher in the 1st month after transplantation: 486 +/- 239 versus 362 +/- 158 ml/min per 1.73 m2. From the 4th to the 6th month after transplantation this difference disappeared: the ERPF of grafts from pediatric donors was 279 +/- 131 ml/min per 1.73 m2 compared with 273 +/- 123 ml/min per 1.73 m2 in grafts from adult donors. Using the single-kidney GFR and ERPF on an age-matched group of probands with minor diseases as references, 2-3 months after transplant the mean GFR of grafts from pediatric donors increased to 118% +/- 51%, whereas the GFR of adult donor grafts fell to 60% +/- 22% over the same period. After 4-6 months the ERPF in pediatric grafts was 96% +/- 55% compared with 50% +/- 22% in adult grafts. We conclude that graft survival and function in children with either a pediatric or an adult graft may not differ because graft function adapts to the requirement of the recipient.
我们根据供体年龄评估了尸体供肾移植的存活率和肾功能。46例患者中儿童供体的中位年龄为7.0（0.7 - 16）岁[中位年龄11.8岁（范围）3 - 16.8岁]。59例患者中成人供体的中位年龄为34.4（19 - 54）岁[中位年龄12.1岁（范围）7 - 17.3岁]。30例患者接受硫唑嘌呤和泼尼松龙治疗，75例接受环孢素A和泼尼松龙治疗。肾移植后1 - 48个月，通过51铬 - 乙二胺四乙酸和125碘 - 马尿酸盐清除率测定肾小球滤过率（GFR）和有效肾血浆流量（ERPF）。儿童和成人供肾移植的存活率没有差异。接受儿童或成人供肾移植患者的GFR也没有差异；移植后2 - 3个月，儿童供肾移植受者的GFR为62±20 ml/min per 1.73 m2，而成人供肾移植受者为61±21 ml/min per 1.73 m2。成人供肾移植受者移植后第1个月的ERPF显著更高：486±239 vs 362±158 ml/min per 1.73 m2。移植后第4至6个月，这种差异消失：儿童供体肾移植的ERPF为279±(131 ml/min per 1.73 m2，而成人供体肾移植为273±123 ml/min per 1.73 m2。以年龄匹配的患有轻微疾病的先证者单肾GFR和ERPF为参考，移植后2 - 3个月，儿童供体肾移植的平均GFR增加到118%±51%，而同期成人供体肾移植的GFR降至60%±22%。4 - 6个月后，儿童肾移植的ERPF为96%±55%，而成人肾移植为50%±22%。我们得出结论，儿童接受儿童或成人供肾移植的存活率和功能可能没有差异，因为移植肾功能适应了受者的需求。
