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相關文獻
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- 處方評估及用藥檢討:腎移植後急性排斥之治療
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- 腎臟移植手術
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頁籤選單縮合
題名 | Long-term Results with Pediatric Kidney Transplants in Adult Recipients=成人接受小兒腎臟移植之長期預後 |
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作者 | 陳呈旭; 徐國雄; 楊啟瑞; 鄭志雄; 吳明儒; 連榮達; | 書刊名 | 臺灣醫學會雜誌 |
卷期 | 98:12 1999.12[民88.12] |
頁次 | 頁807-813 |
分類號 | 416.273 |
關鍵詞 | 腎臟移植; Cadaveric donor; Child; Kidney transplantation; End-stage renal disease; Graft survival; |
語文 | 英文(English) |
英文摘要 | The shortage of donor kidneys available for transplantation has resulted in an expansion of the criteria used for donor selection. The use of cadaveric pediatric kidneys has been suggested as a means to overcome this shortage, but is debated because of technical complications and a means to overcome this shortage, but is debated because of technical complications and an increased incidence of functional allograft impairment. We examined the records of all adult patients receiving renal allograft transplants from January, 1983 through December 1994, to determine whether kidneys from pediatric donors can be used safely for transplantation. During the study period, 204 adult patients received kidney transplants. The patients were divided into three groups by donor age:group 1, 26 months to 7 years old (n= 12); group 2, 7 to 14 years old (n=19) ; and group 3, adult donors (n=173) . Cyclosporine-and/or azathioprine-based immunosuppression regimens were used. The three groups did not differ from one anther with respect to recipient age, recipient sex, primary renal disease, human leukocyte antigen (HLA) mismatching, or the proportion of recipients with previous transplants. The graft survival rates at 1 and 3 years, respectively, were 75%and 75% in group 1, 84% and 79% in group 2, and 85% and 72% in group 3 (p>0.05). The patient survival rates at 1 and 3 years, respectively, were 75% and 75% in group 1, 95% and 90% in group 2, and 90% and 83% in group 3 (p>0.05). The frequency of fixed proteinuria (≧ 0.8 gm/ day) in the first 3 years was higher in the two pediatric groups (50%) than in the adult group (28%) (p<0.05). The frequency of surgical complications was higher with pediatric grafts (group 1 vs group 3:67% vs 24%, p<0.005). In particular, group 1 patients had much higher rates of lymphocele (50% vs 8%), renal graft artery stenosis (33% vs 11%), and hydronephrosis (33% vs 9%) than group 3. We conclude that pediatric donor kidneys can be used with reasonable safety, although surgical complications remain a major problem. |
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