ABSTRACT
Objective:
To retrospectively analyze clinical data of
infant donors with
body weight ≤15 kg into
children recipients, and to investigate the
efficacy and
complications under the strategy of pediatric
donor to pediatric recipient (PTP) of pediatric
kidney transplantation allocation.
Methods:
Clinical data of
kidney transplantation for
children with
infant donors performed in the First Affiliated
Hospital of Zhengzhou
University from August 2010 to December 2019 were collected.Clinical data of
donors and recipients, postoperative adverse events, postoperative renal recovery, and
human and renal
survival were analyzed.
Results:
A total of 50
infant donors and 93 pediatric recipients were enrolled in this study.Recipients included 89
patients with
single kidney transplantation (SKT) and 4 with en-bloc
kidney transplantation (EBKT). The major perioperative
complications were
delayed graft function (DGF) (5 cases, 5.4%) and vascular
thrombosis (VT) (3 cases, 3.2%), followed by
recurrence of primary nephropathy (3 cases, 3.2%),
respiratory tract infection (3 cases, 3.2%), and acute rejection (AR) (2 cases, 2.2%). During the follow-up period, the main
cause of death was
respiratory tract infection (4 cases, 4.3%). Except for the
cause of death, the main causes of
graft loss were rejection (2 cases, 2.2%) and
recurrence of primary
kidney disease (2 cases, 2.2%).
Serum creatinine decreased progressively from (824.77±150.24) μmol/L preoperatively to (90.73±47.24) μmol/L 1 month postoperatively.In SKT group, the median follow-up
time was 31 months (3-74 months), and the
survival rates of recipients and transplanted
kidneys at 1, 3 and 5 years postoperatively were 97.5%/94.2%, 96%/88.8% and 93.1%/86.1%, respectively.In EBKT group, the median follow-up
time was 50 months (13-65 months), and the
survival rates of recipients and transplanted
kidneys at 1, 3 and 5 years postoperatively were all 100.0%.During the fo-llow-up period, there was no significant difference in the
human/
kidney survival rate between groups (all P>0.05), and well acceptable
transplantation outcomes were obtained.
Conclusions:
Single/double
kidney transplantation for
children and
adolescent recipients from
infant donors in the First Affiliated
Hospital of Zhengzhou
University has achieved acceptable outcomes.Adopted by the PTP strategy, the
incidence of
complications after
kidney transplantation does not increase, indicating its
safety and reliability.