儿童DCD供肾成人单肾移植与标准DCD供肾移植临床疗效比较研究

Single Pediatric Kidney Transplantationin Adult Recipients Versusstandard-Criteria Deceased-Donor Kidney Transplantation

目的比较儿童DCD供肾成人单肾移植与标准DCD供肾移植(成人供肾成人单肾移植)的临床疗效。方法回顾性分析本院2011年11月至2014年4月完成的97例DCD供肾移植供受者的临床资料。根据供者年龄将其分为儿童DCD供肾成人单肾移植组(SPKT组,3岁<年龄<18岁,20例)和标准DCD供肾移植组(SCDKT组,年龄≥18岁,73例),比较两组供受者一般情况、受者术后不同时间点血肌酐水平、各种并发症的发生率及移植肾和人的1年存活率。结果 SPKT组供者年龄、体重、移植肾长度显著小于SCDKT组,差异具有统计学意义(P<0.01);SPKT组受者术后1年内蛋白尿发生率显著高于SCDKT组(P<0.01);两组受者移植肾和人的1年存活率比较无统计学差异(P>0.05);供受者其它指标比较均无统计学差异(P>0.05)。结论与标准DCD供肾移植相比,尽管蛋白尿发生率较高,但儿童DCD供肾成人单肾移植近期临床效果良好,远期效果有待进一步研究。

Objective To compare the outcomes of single pediatric kidney transplantations (SPKT )and standard-criteria deceased-donor kidney transplantation (SCDKT)in adult recipients. Methods A retrospec-tive review of clinical history of 97 kidney transplantations from donation after deceased cardiac donors (DCD) performed in our hospital between November 2011 and April 2014 . The patients were classified into single pediat-ric kidney transplantation group (SPKT group,3<donor age<18,n = 20)and standard-criteria deceased-donor kidney transplantation group (SCDKT group,donor age≥18,n = 73). Basic characteristics and evolu-tion of the recipients were compared between the two groups. Results The donor age,weight and length of kid-ney was significantly lower in SPKT group than that of SCDKT group(P<0. 01). There was a significantly high-er incidence of proteinuria in the SPKT cohort compared with SCDKT(P<0. 01). Patient and graft survival at 1 year after SPKT was similar with that for SCDKT. There was no significantly difference in other index between the two groups. Conclusions Although a higher incidence of post-transplantation proteinuria,short-term out-comes of single pediatric kidney transplantations in adults are satisfactory when compared to SCDKT. Long -term results need to be further studied.