ABSTRACT
This article reported a case of fetal giant hepatic hemangioma with cardiomegaly managed with intrauterine treatment. At 23 weeks of gestation, the patient was referred to Guangdong Women and Children Hospital due to abnormal abdominal echogenicity of the fetus, which was suspected to be a hepatic hemangioma or a hepatic arteriovenous fistula. The prenatal ultrasound at 26 weeks of gestation revealed an enlarged fetal hepatic hemangioma of 45 mm×35 mm×42 mm and an enlarged heart (cardiothoracic area ratio of 0.50). So, with the patient's informed consent, the fetus was treated with intrauterine administration of propranolol and dexamethasone and closely monitored by ultrasound. The volume of the lump still increased at the beginning of the medication, but started to shrink in the 7th week. Besides, the fetal cardiac load was reduced and the condition was controlled. The patient delivered at 37 weeks of gestation. The baby received a CT examination on the fourth day after birth which revealed an abdominal mass of 40 mm×30 mm×44 mm requiring no treatment, and no abnormalities were reported during a one-year follow-up.
ABSTRACT
Objective To summary the clinical data of pediatric renal transplantation from multiple renal transplant centers in China,and analyze the factors influencing the therapeutic outcomes of pediatric renal transplantation.Methods From March 1986 to May 2010,the clinical data of 138 children who underwent renal transplantation in eight centers of renal transplantation in China were retrospectively analyzed.Results The one-year patient and graft survival rate was 99.3％ and 95.7％respectively.Acute rejection episodes occurred in 38 cases (27.5％),15 cases suffered delayed graft function (DGF),and graft functions were returned to normal in all recipients within one month.Moreover,other complications included transplant renal artery stenosis in 8 cases (5.8％),ureteral necrosis in 2 cases (1.4％),urinary fistula in 5 cases (3.6％),hypertension in 57 cases (41.3 ％),hyperlipidemia in 38 cases (27.5％),hirsutism in 32 cases (23.2％),drug-induced liver damage in 26 cases (18.8％),urinary tract infection in 25 cases (18.1％ ),gingival hyperplasia in 22 cases (15.9％),pulmonary infection in 21 cases (15.2％),bone marrow suppression in 12 patients (8.7％),herpes simplex in 10 cases (7.2％),and diabetes in 8 cases (5.8％).The body weight was increased by 4 to 13 kg and the body height was increased by 2 to 7 cm during the first year posttransplantation. Conclusion The careful perioperative management, rational use of immunosuppressive agents,strengthening the follow-up management of children and social support,and improving compliance were the key points to obtain good outcomes in pediatric renal transplantation.
ABSTRACT
Objective To investigate the technical features, postoperative complication and therapeutic regimen of immunosuppressant in pediatric and adolescent renal transplantation. Methods From February 1998 to December 2004, clinical data of 46 pediatric and adolescent patients who underwent renal transplantation were retrospectively analyzed to observe the patient and graft survival rate, growth and development of recipients and postoperative complication. Results Ten episodes of acute rejection (AR) were diagnosed in 46 cases. Four cases suffered delayed graft function (DGF), one urinary leakage and 8 drug-induced hepatic injury occurred. Eight cases suffered pulmonary infection, 3 cases suffered bone marrow depression and 2 granulocytopenia. One allograft artery stenosis and one ureteral necrosis occurred. Renal functions were returned to normal in all recipients 4 weeks after operation. The 1-year patient and graft survival rates were all 100 %, and the 3-year patient and graft survival rates were 100 % and 97.4 % respectively. Conclusions Renal transplantation is an effective treatment for pediatric and adolescent patients with end-stage renal disease. In addition to its higher AR incidence than adult, pediatric renal transplantation has especial treatment in the operation process and therapeutic regimen of immunosuppressant.