| Purpose To explore the clinical characteristics of pediatric donors for renal transplantation, improve the effect of pediatric donors, and expand the organ donor pool.Methods The clinical datas of 86 recipients and 47 pediatric donors were retrospectively analyzed in the First Affiliated Hospital between January 2012 and April 2016. Recipients younger than 18 years old were divided into pediatric recipients group(54 cases), and recipients over than 18 years were divided into adult receptor group(32 cases),then compared the level of serum creatinine in different time, adverse events and the survival rate of recepients and graft between two groups after renal transplantation. On the second, we compared the effect of renal transplantion between the 86 recipients from pediatric donors and 132 recipients from adult donors.Datas was analyzed by using the SPSS 19.0. Continuous variables was expressed by mean and standard deviation.Results 1 Result from comparision between pediatric and adult recipients from pediatric donors 1.1 The basic datas of pediatric donors between pediatric and adult recipients from pediatric donors The average age of donors in pediatric recipients group was(5.4 ± 3.9)years and much smaller than the average age of donors in adult recipients group(9.3 ± 4.7)years(P<0.01). The average weight of donors in pediatric recipients group was(21.0 ± 9.6)kg, and less than the average weight of donors in adult recipients(31.2 ± 14.3)kg(P<0.01). The renal length to diameter in pediatric recipients group was(6.3 ± 0.9)cm, less than adult recipients group(8.1 ± 1.0)cm(P<0.05).The cold and warm ischemia time of graft between the two group had no statistical difference(P<0.05). 1.2 The basic datas of pediatric and adult recipients The average age of pediatric recipients was(11.9 ± 3.6)years,and much smaller than adult recipients group(35.8 ± 9.9)years(P<0.01). The average weight of pediatric recipients was(35.4 ± 9.7)kg, and less than adult recipients group(56.8 ± 8.1)kg(P<0.05).Time of preoperative dialysis and the difference between HLA mismatching loci in two groups had no statistical significance(P>0.05). 1.3 Post-operative complications in pediatric recipients group and adult recipients group Incidence of postoperative complications between the two groups had no statistical significance(P>0.05), In pediatric recipients group 2 cases had DGF, were conventional to receive hemodialysis or peritoneal dialysis, and then renal function came back to be normal after a month. 2 cases were emerged with acute rejection in pediatric recipients group. In adult recipients group, 1 case developed to be acute rejection.It was treated with ATG and methylprednisolone and then the level of serum creatinine decreased to be normal.In pediatric recipients group,6 cases were diagnosed with pulmonary infection. Among them 1 case finally died of respiratory failure.In adult recipients group there were 3 cases were diagnosed with pulmonary infection, all of which cured by anti-infection treatment.In pediatric recipients group, there was 1 case with renal allograft vascular stenosis, In adult recipients group there were 2 case with renal allograft thrombosis. The incidence of albuminuria between pediatric recipients group and adult recipients group in the first year was respectively 24.1% and 21.9%,and it had no statistical significance between the two groups(P<0.05). 1.4 The change of serum creatinine and the survival rate of recepients and graft in the first year. The level of serum creatinine in pediatric recipients group dropped to be normal in one week,and it gradually declined to be normal in adult recipients group after two weeks.The survival rate of recepients and graft were respectively 98.1%/98.1% and 100%/93.8% in the first year, and the difference between two groups have no statistical significance(P<0.05). 2 Comparision between recipients from pediatric donors and adult donors 2.1 Post-operative complications Recipients from pediatric donors has a significantly higher incidence of albuminuria and hematuresis than recipients from adult donors in the first year(P<0.05). Other complications between two groups had no statistical significance(P > 0.05) 2.2 The change of serum creatinine and the survival rate of recepients and graft between two groups. Postoperative serum creatinine in two groups fell good.The survival rate of recepients and graft between recipients from pediatric donors and adult donors were respectively 98.1%/96.5% 和 98.5% 及 98.5%, it had no statistical significance between two groups(P > 0.05).Conclusion Renal transplantion using pediatric donors are safe and feasible, and has high clinical value.Expanding the organ donor pool could save more patients with end-stage renal disease. |
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