357例儿童死亡后器官捐献供肾移植血栓性并发症回顾性分析

目的 回顾性分析本中心儿童死亡后器官捐献(deceased donor,DD)供肾移植血栓性并发症的发生率以及相关影响因素.方法 收集中南大学湘雅二医院2012年1月—2018年12月完成的357例儿童DD供肾移植相关资料,将其分为三组,将297例单肾移植设为组一,60例双肾移植中,32例供体满足三"5"原则(供体年龄...

Thrombotic complications of kidney transplantation from deceased pediatric donors:a retrospective study of 357 cases

Objective To retrospectively analyze the incidence of thrombotic complications of kidney transplantation from deceased pediatric donors and the related influencing factors in the Second Xiangya Hospital.Methods A retrospective analysis of 357 cases of kidney transplantation from deceased pediatric donors in our hospital between January 2012 and December,2018 was performed.The cases are divided into three groups as following:297 cases of single kidney transplant as group 1,32 cases of double kidney transplant recipients who meet the three"5"principles(donor age>5 month,donor weight>5 kg,renal length>5 cm)as group 2,a total number of 28 cases of double kidney transplant recipients who did not meet the three"5"principle as group 3.Then the relationship between the incidence of thrombotic complications and donor age,donor renal size and the operation methods were analyzed.Results In the group of 297 single renal transplant recipients,2 cases had thrombotic complications;the incidence was 0.67%,which was caused by surgical error.There were no thrombotic complications for 32 recipients of double kidney transplantation in the group 2,however,one patient developed renal artery stenosis.Five cases had renal embolization in those using separate double kidney transplant operation in group 3,includng 3 cases of single renal artery embolism,1 case of bilateral renal artery embolization and 1 case of single renal vein embolism.The incidence was 17.8%in group 3.However,18 cases of recipients who receiving"en bloc kidney transplantation(EBKT)using the distal abdominal aorta as an outflow tract"had no embolism events.Conclusion The incidence of thrombotic complications of kidney transplantation from deceased pediatric donors is related to donor age,donor kidney size and surgical technique.Donor age<5 months,donor weight<5 kg and donor kidney length<5 cm,the incidence of embolism was significantly increased.“EBKT using the distal abdominal aorta as an outflow tract”had a low incidence of embolism,seemed to be an effective method to solve the problem of high incidence of embolism in kidney transplantation from neonatal donors,but expanded samples size and long-term follow-up are still needed.