低龄儿童 DCD 单侧供肾用于成人肾移植的单中心经验
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国家自然科学基金面上项目(81470981,81570676),国家自然科学基金青年基金项目(81100532),江苏省“333高层次人才培养工程”项目(2011,2013),江苏省“科教兴卫”工程医学重点人才培养资助项目(RC2011055),江苏省“六大人才高峰”资助项目(2011?WS?033,2010WSN?56)


Application of single kidney from pediatric DCD donors ≤ 5 years of age in adult recipients transplantation:Single center experience
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    目的:分析低龄儿童单侧供肾在成人肾移植中的临床效果。方法:回顾性分析南京医科大学第一附属医院2013年11月—2016年9月期间6例低龄儿童公民逝世后器官捐献(donation after citizen’s deceased,DCD)单侧供肾肾移植的临床资料。结果:6例成人受体接受了来自5例低龄儿童DCD单侧供肾。供体中位月龄50个月(20~60个月),中位体重15.5 kg(12.0~17.0 kg)。受体中位年龄25岁(18~31岁),中位体重43.5 kg(34.0~55.0 kg),中位体重指数(body mass index,BMI)18.3 kg/m2(14.7~22.0 kg/m2)。随访期间,术后受体的血肌酐水平逐渐下降,估算的肾小球滤过率(estimated glomerular filtration rate,eGFR)水平稳步升高,术后半年至3年内肾功能稳定在正常范围。移植肾长径在术后2周内迅速增长(P=0.042),术后1年内进一步生长。移植肾及人6 个月及1年存活率均为100%。结论:低龄儿童单侧供肾用于成人肾移植是可行、有效的,这将为扩大供肾来源带来希望。

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    Objective:To analyze the clinical effect of single kidney from pediatric donors ≤ 5 years of age in adult recipients transplantation. Methods:A retrospective study was conducted to analyze the clinical data of nine adult recipients recieving single kidney from pediatric donors from November 2013 to September 2016 in the First Affiliated Hospital with Nanjing Medical University. Results:Six adult recipients received single kidney from five pediatric donors ≤ 5 years of age. For the donors,the median age was 50 months(range,20 to 60 months)and the median weight was 15.5 kg(range,12.0 to 17.0 kg). Six recipients were female,with their median age 25 years(range,18~31 years),their median weight 43.5 kg(range,34.0~55.0 kg),their median BMI 18.3(range,14.7~22.0). During the follow-up period,the recipients’ serum creatinine level gradually decreased,and their eGFR increased steadily. The renal function stayed stable within six months to three years after transplantation. The long diameter of the transplanted kidney grew rapidly within 2 weeks after operation(P=0.042),and further growth occurred within 1 year after operation. The 1-year patient/graft survival was 100%. Conclusion:Single renal supply from pediatric donors ≤ 5 years of age is feasible and effective for adult recipients transplantation.

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孙 黎,韩志坚,居小兵,陶 俊,陈 浩,谭若芸,顾 民.低龄儿童 DCD 单侧供肾用于成人肾移植的单中心经验[J].南京医科大学学报(自然科学版),2019,(2):215-219

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  • 收稿日期:2017-12-13
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  • 在线发布日期: 2019-03-06
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