儿科移植 - 活着的还是已故的捐赠者?
Catarina Isabel Madeira Rodrigues Neves1, Ana Rita Gomes Carlos Leal2, Lídia Simões Dos Santos2
1Pediatric Nephrology Unit, Pediatric Hospital of Coimbra, Hospital and University Center of Coimbra, Coimbra, Portugal.
Transplantation proceedings
|July 7, 2023
概括
与已故捐赠者移植相比,来自活体捐赠者的儿科移植提供了更好的结果,包括预防性手术和改善的移植存活率. 这凸显了供体选择在儿科末期病管理中的重要性.
科学领域:
- 儿科脏病学 儿科脏病学
- 移植手术 移植手术
- 免疫遗传学 免疫遗传学
背景情况:
- 移植是儿科末期病 (ESRD) 的最佳治疗方法.
- 捐赠者选择对于年轻移植受体的长期成功至关重要,因为他们的预期寿命更长.
- 优化生长,发育和生活质量是儿科移植的关键目标.
研究的目的:
- 为了比较小儿科患者的移植的短期和长期结果,使用活体与已故的捐赠者.
- 评估捐赠者类型对预防性移植率,HLA兼容性和移植存活率的影响.
- 为儿童移植接受者提供捐赠者选择策略的信息.
主要方法:
- 在1999年1月至2018年12月期间接受移植的儿科患者 (<18岁) 的回顾性分析.
- 活体捐赠脏移植 (LDKT) 和已故捐赠脏移植 (DDKT) 之间的结果比较.
- 评估变量,包括预防性状态,HLA不匹配,捐赠者年龄,住院时间,并发症和移植/患者存活率.
主要成果:
- 活体供体移植更频繁地具有预防性 (58.3%对4.3%) 并显示出优异的HLA兼容性 (≤3个不匹配:90.9%对13.0%).
- 接受LDKT的患者住院时间较短 (8.8 vs 14.1天),捐赠者年龄较大 (38.4 vs 24.3年).
- 虽然短期并发症和存活率相似,但13年移植存活率显著高于LDKT (91.7%vs72.3%).
结论:
- 在儿科患者中,活体捐赠者的移植与更高的预防性移植的可能性有关.
- LDKT导致更好的HLA匹配,更短的住院时间,并提高了长期的移植存活率.
- 这些发现强调了活体捐赠在儿科移植中的显著益处.
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