단일 센터의 소아 신이식 27례의 임상경험
Clinical Experience of 27 Pediatric Renal Transplantation at a Single Center
김기호, 예석준, 김재수, 권태균, 정성광,
소속 상세정보
김기호 ( Kim Ki-Ho )
경북대학교 의과대학 비뇨기과학교실
예석준 ( Yae Suk-Jun )
경북대학교 의과대학 비뇨기과학교실
김재수 ( Kim Jae-Su )
경북대학교 의과대학 비뇨기과학교실
권태균 ( Kwon Tae-Gyun )
경북대학교 의과대학 비뇨기과학교실
정성광 ( Chung Sung-Kwang )
경북대학교 의과대학 비뇨기과학교실
KMID : 0358320070480010072
Abstract
Purpose: Renal transplantation is considered the treatment of choice for children with end-stage renal disease(ESRD). The results of renal transplantation were retrospectively analyzed to assess certain aspects of pediatric renal transplantation.
Materials & Methods: Between January 1989 and January 2005, 27 pediatric kidney transplantations were carried out at our center. Fifteen (55.5%) patients underwent hemodialysis, two(7.4%) peritoneal dialysis and ten(37.0%) were conservative managed prior to treatment. Living- related donors provided 25(92.6%) of the transplanted organs, with cadaver sources utilized for 2(7.4%) patients. The donor age, organ source, etiology of ESRD, hospitalization period, postoperative complications, occurrence and number of acute rejections, and graft survival were assessed.
Results: The causes of renal failure were chronic glomerulonephritis in 10 patients[IgA 3 nephropathy, 3 membranoproliferative glomerulonephritis(MPGN), 2 nephrotic syndrome and 2 focal segmental glomerulosclerosis (FSGS)], urinary tract anomalies in 6(4 reflux nephropathy and 2 polycystic kidney), Alport syndrome in 1, hypertensive nephropathy in 2, systemic immunological disease in 1 and unknown causes in a further 5. Acute rejection occurred in 12 patients, all of who recovered after steroid pulse therapy. Growth and development failed in 2 patients. The postoperative complications included 4 urinary tract infections, 3 retroperitoneal hematomas, 2 lymphoceles and 1 acute ureteral obstruction. Four patients expired due to post-operative complications, such as disseminated intravascular coagulation(DIC), intracranial hematoma, sepsis and renal failure.
Conclusion: Pediatric renal transplantation can be successful, even in young children with ESRD.(Korean J Urol 2007;48:72-76)
키워드
Kidney transplantation;Children
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