儿童单侧供肾成人肾移植单中心疗效分析

刘克普; 李智斌; 王会龙; 韩士超; 张更

doi:10.3969/j.issn.1674-7445.2021.05.015

儿童单侧供肾成人肾移植单中心疗效分析

doi: 10.3969/j.issn.1674-7445.2021.05.015

710032 西安，空军军医大学西京医院泌尿外科

基金项目:

陕西省资源主导型产业关键技术(链)项目 2012KTCL03-03

军事医学创新工程项目 16CXZ023

西京医院学科助推计划 XJZT18ML04

详细信息

作者简介:
刘克普，男，1983年生，硕士，主治医师，研究方向为肾移植及泌尿生殖系肿瘤的微创治疗，Email：liukepu@126.com

通讯作者:
张更，男，1976年生，博士，副主任医师，研究方向为肾移植及泌尿生殖系肿瘤的微创治疗, E-mail: zuibingling@163.com

中图分类号: R617, R692.5
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出版历程
- 收稿日期: 2021-04-21
- 网络出版日期: 2021-09-15
- 刊出日期: 2021-09-15

Clinical efficacy of adult kidney transplantation from unilateral pediatric donor kidney

Department of Urology, Xijing Hospital, Air Force Medical University, Xi'an 710032, China

More Information

Corresponding author: Zhang Geng, E-mail: zuibingling@163.com

摘要

摘要: 目的探讨儿童单侧供肾用于成人肾移植的临床疗效。方法回顾性分析肾移植儿童供者(10例)及成人受者(19例)的临床资料。比较受者术后1、7、14、28、60 d肾功能、肝功能、移植肾长径变化情况；分析受者的近期生存情况及术后并发症的发生情况。结果供者男6例，女4例，年龄(7±3)岁，体质量指数(BMI)为(16.3±3.8)kg/m²，均为脑-心双死亡器官捐献。受者男12例，女7例，年龄(34±12)岁，BMI为(20.3±1.3)kg/m²。受者取右下腹斜形切口，将供肾动、静脉与受者髂外动、静脉端侧吻合，供肾输尿管与受者膀胱吻合，吻合完毕放置右侧髂窝并固定。肾移植受者术后1周血清肌酐和血尿素氮水平下降，2周时接近正常水平。术后受者肝功能各项指标正常。术后1个月移植肾长径为(9.5±0.3)cm，基本达到成人正常值。19例受者术后1年生存率为95%。1例受者发生肺部感染，治疗无效死亡。2例发生排斥反应，1例发生泌尿系统感染，治疗后均痊愈。结论儿童单侧供肾用于成人受者肾移植安全可行，临床效果良好，可作为扩大供肾来源的有效途径。
- 儿童供肾 /
- 肾移植 /
- 血清肌酐 /
- 血尿素氮 /
- 移植肾长径 /
- 感染 /
- 并发症 /
- 肝功能
Abstract: Objective To evaluate the clinical efficacy of adult kidney transplantation from unilateral pediatric donor kidney. Methods Clinical data of pediatric donors (n=10) and adult recipients (n=19) undergoing kidney transplantation were retrospectively analyzed. The changes of renal function, liver function and the maximal diameters of the kidney allografts were compared at 1, 7, 14, 28, 60 d after operation. The short-term survival and incidence of postoperative complications of the recipients were analyzed. Results Ten donors included 6 males and 4 females, aged (7±3) years old, with a body mass index (BMI) of (16.3±3.8) kg/m². All donors were donation after brain death followed by cardiac death. Among 19 recipients, 12 were males and 7 were females, aged (34±12) years old, with a BMI of (20.3±1.3) kg/m².An oblique incision was created in the lower right abdomen of the recipients. The arteries and veins of donor kidney were anastomosed with the external iliac arteries and veins of the recipients. The ureter of donor kidney was anastomosed with the bladder of the recipients. After anastomosis, the kidney was placed and fixed in the right iliac fossa. The serum creatinine and blood urea nitrogen levels of the recipients were decreased at 1 week after kidney transplantation, and restored to normal range at postoperative 2 weeks. All parameters related to liver function were normal after operation. At postoperative 1 month, the maximal diameters of the kidney allografts were (9.5±0.3) cm on average, which basically reached those of normal adults. The 1-year survival rate of 19 recipients was 95%. One recipient died from pulmonary infection after ineffective treatment. Two recipients developed rejection, and 1 recipient experienced urinary system infection, who were healed after corresponding treatment. Conclusions Adult kidney transplantation from unilateral pediatric donor kidney is safe, feasible and effective, which can be utilized to enlarge the source of donor kidneys.
- Pediatric donor kidney /
- Kidney transplantation /
- Serum creatinine /
- Blood urea nitrogen /
- Maximal diameter of kidney allograft /
- Infection /
- Complication /
- Liver function

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图 1 受者术后血清肌酐和血尿素氮变化趋势

Figure 1. The change trend of serum creatinine and blood urea nitrogen in recipients after operation

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图 2 受者术后肝功能变化趋势

Figure 2. The change trend of liver function in recipients after operation

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图 3 移植肾长径变化趋势

Figure 3. The change trend of the maximal diameter of kidney allografts

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