Warady B A, Hébert D, Sullivan E K, Alexander S R, Tejani A
Children's Mercy Hospital, Kansas City, Missouri, USA.
Pediatr Nephrol. 1997 Feb;11(1):49-64. doi: 10.1007/s004670050232.
The 1995 Annual Report of the North American Pediatric Renal Transplant Cooperative Study summarizes data voluntarily collected from 123 centers on 5,197 children and adolescents grouped into three cohorts: (1) patients who received renal transplants on or after 1 January 1987 (n = 3,066), (2) patients who were maintained on peritoneal dialysis (PD) or hemodialysis (HD) on or after 1 January 1992 (n = 1,488), and (3) patients treated for chronic renal insufficiency (CRI) on or after 1 January 1994 (n = 643). The transplant and dialysis information update previous registry data whereas the CRI information reflects 1st-year registry data. Three-year graft survival rates were 83% and 66% for living donor grafts and cadaver donor (CD) grafts, respectively. Triple drug maintenance therapy with prednisone, cyclosporine, and azathioprine was used by > 70% of all transplant recipients through 5 years of follow-up. The 2-year CD survival has steadily improved from 65% in 1987 to 82% in 1992. Fifty malignancies have been reported, the majority of which are lymphoproliferative disorders. The 2-year patient survival posttransplantation is 95%. Mortality rates for the youngest patients have drastically improved over the past 2 years. Approximately two-thirds of patients in the dialysis cohort are maintained on PD; automated PD remains the preferred modality. Overall, the peritonitis rate is one infection every 13.3 patient months, the frequency of infection being greatest in the youngest patients. Whereas the primary reason for dialysis modality termination is transplantation approximately 40% of the entire dialysis cohort (PD at HD) were not considered active transplant candidate Baseline CRI data revealed the most common primary diagnoses to be obstructive uropathy (24%) and aplastic/hypoplastic/dysplastic kidneys (19%). The standardized height deficit in the CRI cohort was greatest in the younger patients and those with the most impaired renal function.
北美儿科肾移植协作研究1995年年报总结了从123个中心自愿收集的数据，这些数据涉及5197名儿童和青少年，他们被分为三个队列：（1）1987年1月1日或之后接受肾移植的患者（n = 3066），（2）1992年1月1日或之后接受腹膜透析（PD）或血液透析（HD）维持治疗的患者（n = 1488），以及（3）1994年1月1日或之后接受慢性肾功能不全（CRI）治疗的患者（n = 643）。移植和透析信息更新了先前登记处的数据，而CRI信息反映的是第一年登记处的数据。活体供体移植物和尸体供体（CD）移植物的三年移植物存活率分别为83%和66%。在5年的随访中，超过70%的移植受者使用泼尼松、环孢素和硫唑嘌呤进行三联药物维持治疗。CD移植物的2年存活率已从1987年的65%稳步提高到1992年的82%。已报告50例恶性肿瘤，其中大多数是淋巴增生性疾病。移植后2年患者存活率为95%。在过去2年中，最年轻患者的死亡率大幅下降。透析队列中约三分之二的患者接受PD维持治疗；自动化腹膜透析仍然是首选方式。总体而言，腹膜炎发生率为每13.3个患者月发生1次感染，感染频率在最年轻患者中最高。虽然透析方式终止的主要原因是移植，但整个透析队列中约40%（PD或HD）的患者不被视为积极的移植候选者。CRI基线数据显示，最常见的主要诊断是梗阻性尿路病（24%）和发育不全/发育不良/发育异常的肾脏（19%）。CRI队列中标准化身高缺陷在较年轻患者和肾功能受损最严重的患者中最大。
