婴幼儿脑死亡后供者器官捐献供肾成人双肾移植23例

Reports of 23 cases of dual kidney transplantation from donation after brain death pediatric donors to adult recipients

目的 探讨婴幼儿脑死亡器官捐献供肾成人双肾移植的临床疗效.方法 23例婴幼儿脑死亡供肾成人双肾移植.23例供者的年龄为50 d至37个月,体质量为2.8～11.5 kg;23例受者的年龄为15～63岁,体质量为42.8～66.0 kg.32例中,整块移植8例,分离式双肾移植15例.结果 23例双肾移植受者中,1例发生移植肾功能恢复延迟,予规律血液透析治疗20 d后恢复.供者年龄大于5个月的19例受者未常规抗凝血,无一例血栓形成;供者年龄小于3个月的有4例,其中1例发生双肾栓塞,2例发生单肾栓塞,术后出现中到大量蛋白尿.结论 婴幼儿脑死亡供肾成人双肾移植临床效果良好,可作为扩大供者来源的途径之一.

Objective To investigate the clinical effect of dual kidney transplantation from donation after brain death （DBD） pediatric donors to adult recipients.Method Twenty-three cases of dual kidney transplantation from DBD pediatric donors to adult recipients were analyzed.Donors＂ age ranged from 50 days to 37 months,and body weight ranged from 2.8 to 11.5 kg.The age of recipients ranged from 15 years to 44 years and weighted from 42.8 to 66.0 kg.Dual en bloc kidney transplantations were performed on 8 cases,and dual separating kidney transplantations on 15 cases.Result One patient was diagnosed as delayed graft function,and graft function recovered after 20 days of hemodialysis.Nineteen cases who met the three ＂5＂ principle didn＇t receive prophylactic anticoagulation,and no thrombotic complication occurred.In 4 cases who didn＇t meet the three ＂5＂ principle,bilateral renal embolism occurred in 1 case and unilateral renal embolism occurred in 2 cases,and middle to large amount of proteinuria was found during the follow-up period.Conclusion The clinical effect of dual kidney transplantation from DBD pediatric donors to adult recipients is satisfactory.Making full use of these organs was an efficient way to expand the donor pool.