المؤلفون: |
Zhu KL; Department of Kidney Transplantation, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China., Feng YH; Department of Kidney Transplantation, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China., Hu MY; Department of Kidney Transplantation, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China., Cui KX; Department of Kidney Transplantation, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China., Shang WW; Department of Kidney Transplantation, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China., Liu L; Department of Kidney Transplantation, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China., Wang JX; Department of Kidney Transplantation, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China., Wang ZG; Department of Kidney Transplantation, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China., Zhang LY; Department of Kidney Transplantation, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China., Cheng FM; Department of Kidney Transplantation, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China., Zhang J; Department of Kidney Transplantation, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China., Wang ZQ; Department of Kidney Transplantation, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China., Feng GW; Department of Kidney Transplantation, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China. |
مستخلص: |
Objective: To evaluate the short-and mid-term efficacy of pediatric kidney transplantation and the risk factors for kidney graft and recipient. Methods: The baseline data and postoperative complications of pediatric donors and recipients of 284 kidney transplants were retrospectively analyzed in the Department of Kidney Transplantation in the First Affiliated Hospital of Zhengzhou University from August 2010 to May 2021 and all subjects were followed up until December 31, 2021. According to the survival status of donors and recipients, they were divided into the graft-loss group and the graft-survival group, and the recipient death group and survival group, respectively. Univariate comparison between groups was performed by Log-rank test, and Cox proportional risk model was used to explore the independent risk factors for the graft and recipient survival. Results: Among the 284 children recipients, 184 cases (64.8%) were male and 100 cases(35.2%) were female, and 19 cases (6.7%) were living relative donor renal transplantation, 19 cases (6.7%) were preemptive transplantation, and 8 cases were secondary transplantation. The age of 284 recipients at the time of transplantation was 13.0 (9.0, 15.0) years, among whom 29 cases aged 0-6 years, 96 cases aged 7-11 years old, and 159 cases aged 12-18 years. The 1, 3, and 5 year survival rates were 92.3%, 88.9% and 84.8% for the kidney grafts, and were 97.1%, 95.6% and 94.4% for the recipients, respectively. Multivariate analysis showed postoperative acute rejection ( HR= 3.14, 95% CI 1.38-7.15, P= 0.006) and perioperative vascular complications ( HR= 4.73, 95% CI 2.03-11.06, P< 0.001) were independent risk factors for the survival of kidney graft. Postoperative infection ( HR= 14.23, 95% CI 3.45-58.72, P <0.001) was an independent risk factor for the postoperative mortality of recipients. Conclusions: Pediatric kidney transplantation shows a good short-and mid-term prognosis. Postoperative acute rejection and perioperative vascular complications are the risk factors for the survival of kidney graft, and postoperative infection is the risk factor affecting the survival of recipient. |