当前位置: X-MOL 学术Am. J. Transplant. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Urologic complications after transplantation of 225 en bloc kidneys from small pediatric donors ≤20 kg: Incidence, management, and impact on graft survival.
American Journal of Transplantation ( IF 8.8 ) Pub Date : 2020-01-26 , DOI: 10.1111/ajt.15792
Ghaneh Fananapazir 1 , Gary Tse 2 , Ryan Di Geronimo 1 , John McVicar 3 , Richard Perez 3 , Chandrasekar Santhanakrishnan 4 , Junichiro Sageshima 3 , Christoph Troppmann 3
Affiliation  

Pediatric en bloc kidney transplants (EBKs) from small deceased pediatric donors are associated with increased early graft loss and morbidity. Yet, urologic complications post‐EBK and their potential impact on graft survival have not been systematically studied. We retrospectively studied urological complications requiring intervention for 225 EBKs performed at our center January 2005 to September 2017 from donors ≤20 kg into recipients ≥18 years. Overall ureteral complication incidence after EBK was 9.8% (n = 22) (12% vs 2% for EBK donors urn:x-wiley:16006135:media:ajt15792:ajt15792-math-000110 vs urn:x-wiley:16006135:media:ajt15792:ajt15792-math-000210 kg, respectively [P  = .031]). The most common post‐EBK urologic complication was a stricture (55%), followed by urine leak (41%). In all, 95% of all urologic complications occurred early within 5 months posttransplant (median, 138 days). Urologic complications could be successfully managed nonoperatively in 50% of all cases and had no impact on graft or patient survival. In summary, urologic complications after EBK were common, associated with lower donor weights, occurred early posttransplant, and were often amenable to nonoperative treatment, without adversely affecting survival. We conclude that the higher urologic complication rate after EBK (1) should not prevent increased utilization of small pediatric donor en bloc kidneys for properly selected recipients, and (2) warrants specific discussion with EBK recipients during the preoperative consent process.

中文翻译:

225 个 ≤20 公斤的小儿科供体整块肾脏移植后的泌尿系统并发症:发生率、管理和对移植物存活率的影响。

来自小型已故儿科供体的儿科整块肾移植 (EBK) 与早期移植物丢失和发病率增加有关。然而,EBK 术后泌尿系统并发症及其对移植物存活的潜在影响尚未得到系统研究。我们回顾性研究了 2005 年 1 月至 2017 年 9 月在我们中心进行的 225 例 EBK 需要干预的泌尿系统并发症,供体≤20 公斤,接受者≥18 岁。urn:x-wiley:16006135:media:ajt15792:ajt15792-math-0001EBK 后总体输尿管并发症发生率为 9.8% (n = 22)(10 公斤和10 公斤的 EBK 供体urn:x-wiley:16006135:media:ajt15792:ajt15792-math-0002分别为 12% 和 2% [ P =.031])。最常见的 EBK 后泌尿系统并发症是狭窄 (55%),其次是漏尿 (41%)。总之,95% 的泌尿系统并发症早期发生在移植后 5 个月内(​​中位数,138 天)。在所有病例中,50% 的泌尿系统并发症可以通过非手术方式成功控制,并且对移植物或患者的存活率没有影响。总之,EBK 术后泌尿系统并发症很常见,与较低的供体体重相关,发生在移植后早期,并且通常适合非手术治疗,不会对生存产生不利影响。We conclude that the higher urologic complication rate after EBK (1) should not prevent increased utilization of small pediatric donor en bloc kidneys for properly selected recipients, and (2) warrants specific discussion with EBK recipients during the preoperative consent process.
更新日期:2020-01-26
down
wechat
bug