دورية أكاديمية

[Analysis of prognostic factors of pediatric kidney transplantation].

التفاصيل البيبلوغرافية
العنوان: [Analysis of prognostic factors of pediatric kidney transplantation].
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.
المصدر: Zhonghua er ke za zhi = Chinese journal of pediatrics [Zhonghua Er Ke Za Zhi] 2022 Sep 02; Vol. 60 (9), pp. 888-893.
نوع المنشور: Journal Article
اللغة: Chinese
بيانات الدورية: Publisher: Chinese Medical Association Country of Publication: China NLM ID: 0417427 Publication Model: Print Cited Medium: Print ISSN: 0578-1310 (Print) Linking ISSN: 05781310 NLM ISO Abbreviation: Zhonghua Er Ke Za Zhi Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Beijing : Chinese Medical Association, 1950
مواضيع طبية MeSH: Kidney Transplantation*/adverse effects, Child ; Female ; Graft Rejection ; Graft Survival ; Humans ; Living Donors ; Male ; Postoperative Complications ; Prognosis ; Retrospective Studies ; Risk Factors
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.
معلومات مُعتمدة: SB201901004 Medical Science and Technology Research Project of Henan Province
فهرسة مساهمة: Local Abstract: [Publisher, Chinese] 目的: 评价儿童肾移植术后短、中期疗效及影响移植肾和受者预后的危险因素。 方法: 回顾性分析郑州大学第一附属医院肾移植科2010年8月至2021年5月284例肾移植患儿供、受者移植时基线资料及术后并发症发生情况,随访至2021年12月31日。根据移植肾和受者存活状态,分为移植肾丢失组和移植肾存活组以及受者死亡组和受者存活组,组间单因素比较采用Log-rank检验,Cox比例风险模型探讨影响移植肾丢失和受者死亡的独立风险因素。 结果: 284例患儿中男184例(64.8%),女100例(35.2%);亲属活体供者19例(6.7%),抢先移植19例(6.7%),二次移植患儿8例。284例受者移植时年龄为13.0(9.0,15.0)岁,其中0~6岁29例,7~11岁96例,12~18岁159例。移植肾和受者1、3、5年存活率分别为92.3%、88.9%、84.8%和97.1%、95.6%、94.4%。多因素分析术后急性排斥反应( HR =3.14,95% CI 1.38~7.15, P =0.006)和围术期血管并发症( HR =4.73,95% CI 2.03~11.06, P <0.001)是术后移植肾丢失的独立危险因素。术后感染( HR =14.23,95% CI 3.45~58.72, P <0.001)是受者术后死亡的独立危险因素。 结论: 儿童肾移植术后显示出良好的短、中期预后,术后急性排斥反应和围术期血管并发症是影响移植肾存活的因素,术后感染是影响受者存活的因素。.
تواريخ الأحداث: Date Created: 20220829 Date Completed: 20220831 Latest Revision: 20220831
رمز التحديث: 20221213
DOI: 10.3760/cma.j.cn112140-20220330-00257
PMID: 36038297
قاعدة البيانات: MEDLINE
الوصف
تدمد:0578-1310
DOI:10.3760/cma.j.cn112140-20220330-00257