Clinical analysis of 147 cases of pediatric kidney transplantation with kidney donation after death of minors / 中华器官移植杂志

ABSTRACT

Objective:To explore the feasibility and efficacy of kidney transplantation with pediatric donors to pediatric recipients (PTP) according to the quality control parameters of kidney transplantation in China.Methods:From September 2011 to September 2019, the clinical data were reviewed for 147 children undergoing kidney transplantation. The general status of donors and recipients, survival rate and complications of transplantation were analyzed.The median age was 130(21-270) month and the median weight 26.0(8.5-71.5) kg. The median age of 120 donors was 12 month (4 day-180 month) and the median weight 9.3(2.5-50.0) kg.Results:After a follow-up period of 10 days to 9 years, the cumulative survival rates of patients and grafts were 97.3% and 88.8%. The cumulative survival rates of patients and grafts were 95.7% and 60.9% in en bloc kidney transplant recipients versus 96.8% and 94.2% in single kidney transplant recipients. The major complications of en bloc kidney transplantation were graft thrombosis (47.8%) and ureteral complications (17.4%). Single kidney transplantation was characterized by delayed graft function recovery (DGF, 18.6%) and acute rejection reaction (10.5%). Two cases died from donor-derived infection after transplantation, one from cytomegalovirus infection and one from epileptic seizure.Conclusions:PTP kidney transplantation is effective. Organ matching and optimal operative mode selection are essential. Preventing postoperative thrombosis for avoiding an early graft loss has remained a high priority during PTP kidney transplantation.