婴儿双肾供成人肾移植的临床疗效分析

Clinical efficacy of dual kidney transplantation from infant donors to adult recipients

目的总结分析婴儿双肾供成人肾移植的临床疗效。方法回顾性分析2017年5月1日至2020年6月1日在该院实施的5例婴儿双肾供成人受者的临床疗效及长期随访情况,随访截止时间为2021年7月1日。供者年龄2~11月龄,体重5.2~8.0 kg,供肾长度5.4~7.1 cm;受者年龄23~47岁,体重43.0~52.5 kg,体重指数(BMI)18.05~20.83 kg/m^(2)。结果5例双肾移植受者中,4例采用双供肾单侧移植,1例采用双供肾双侧移植手术方式。5例受者术后均未发生原发性移植肾无功能、血管吻合口狭窄、移植肾动静脉血栓、急性排斥反应和肺部感染等,1例发生移植肾功能恢复延迟;移植肾长度均在术后第1个月呈直线生长,术后6~12个月达峰值;估算肾小球滤过率(eGFR)在移植术后6个月至1年达到100 mL·min^(-1)·1.73 m^(-2);随访期间所有受者的血肌酐水平均稳定在100μmol/L左右;术后均无中到大量蛋白尿;人、肾存活率均为100%。结论婴儿双肾供成人肾移植的移植效果满意,可为进一步提高儿童捐献利用率,改善供肾短缺的现状提供参考。

Objective To summarize and analysize the clinical efficacy of dual kidney transplantation from infant donors to adult recipients.Methods Retrospective analysis was performed on the clinical efficacy and long-term follow-up of five adults undergoing kidney transplantation from infant donors in this hospital from May 1,2017 to June 1,2020.The deadline for follow-up was July 1,2021.The age of donors ranged from two months to 11 months,body weight 5.2-8.0 kg,and donor kidney length 5.4-7.1 cm.The recipients aged 23 to 47 years,body weight 43.0-52.5 kg,body mass index(BMI)18.05-20.83 kg/m^(2).Results Among the five recipients of dual kidney transplantation,four patients underwent unilateral double kidney transplantation,and one patient underwent bilateral double kidney transplantation.None of the five recipients suffered from primary renal graft failure,vascular anastomotic stenosis,arteriovenous thrombosis,acute rejection and pulmonary infection.One of the five recipients had delayed renal function recovery.The length of transplanted kidney all showed straight growth at the first month after surgery,and reached the peak at 6-12 months after surgery.The estimated glomerular filtration rate(eGFR)was about 100 mL·min^(-1)·1.73 m^(-2) at six months to one year after transplantation.During the follow-up period,the blood creatinine values of all receptors were stable at about 100μmol/L.There was no medium to large amount of albuminuria after surgery.Both the recipients and renal survival rates were 100%.Conclusion The clinical effect of dual kidney transplantation from infant donors to adult recipient is satisfactory,which provided reference for further improving the utilization rate of infant donor and improving the shortage of donor kidney.