Puxun Tian, People's Republic of China
Professor
The First affiliated hospital of Xi' An Jiaotong University
Clinical research of kidney transplantation from cardiac death pediatric donors
Han Feng2, Ding Chenguang1, Tian Puxun2, Xue Wujun *1, Ding Xiaoming1, Pan Xiaoming1, Yan Hang1, Xiang Heli1, Hou Jun1, Feng Xinshun1, Tian Xiaohui1, Li Yang1, Zheng Jin1, Wang Xuzhen1.
1Department of Renal Transplantation, Kidney Disease Hospital, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China; 2Organ Transplantation Institute of Xi’an Jiaotong University, Department of Renal Transplantation, Kidney Disease Hospital, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People's Republic of China
Organ Transplantation Institute of XI'an Jiaotong University.
Objective: To investigate the early clinical effect of en bloc kidney transplantation and single kidney transplantation from pediatric donors with donation after cardiac death，comparing with standard DCD donor kidney transplantation (adult single renal transplantation from adult kidney donor).
Methods: A retrospective review of clinical data of donors and recipients kidney transplantation from donation after deceased cardiac donors (DCD) performed from November 2013 to December 2015 in kidney transplantation department of the first affiliated hospital of Xi’an Jiaotong university. Ages of 15 cardiac death pediatric donors：1.5～16years old(8 donors under 8 years, 4 donor from 9 years to 14 years, 3 donors from 15 to 16 years), donated to the same blood recipients all. Total 30 kidneys, acquiring all of them, 28 recipients(2 en bloc kidney transplantation). Protopathy of donors: 11 craniocerebral trauma donors, 1 encephalitis and 1 toxic hepatic disease donor, 2 brain gliomas donors. All operation adopted iliac fossa grafting.
Results: 28 cases of operation are performed well. The median warm ischemic time of renal allografts was 12.5 min (0－17min)，cold ischemic time was 4.3 h (1.5 ～ 7.7 h). 10 donors applied lifepot to reserve organs and 5 didn’t. Recipients: 17 males, 11 females; ages from 7.5 to 63 years old.; weight from 16kg to 56kg; immunosuppressive treatment protocol: ATG+CNI+MMF+Pred; postoperative complications: 4 DGF, 1 dialysis, 2 death, 2 nephrectomy. Postoperative follow-up time was from 1 to 24 months. So far, renal function of 24 recipients with renal survival (24/28=85.7%) all are normal. Comparing with standard DCD donor kidney transplantation during the same period, there are no significantly statistical differences. Kidney volume increases significantly within one month after surgery in single kidney to adult, and long axis of the kidney will be more than 10 cm after half a year.
Conclusions: Short-term out-comes of en bloc kidney transplantation and single kidney transplantation from pediatric donors are satisfactory. After specific, personalized, timely and effective perioperative treatment, there are no obvious differences with standard DCD donor kidney transplantation. Long-term results need to be further studied．It is an effective way to expand kidney source.
Corresponding Author: Tian Punxun, Email: tianpuxunxa@163.com Xue Wujun, Email: xwujun@126.com
References:
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[2] Single Pediatric Kidney Transplantationin Adult Ｒecipients Versusstandard-Criteria Deceased-Donor Kidney Transplantation. Journal of Urology. 2015, 7(2):27-32.
[3] Neonatal and Pediatric Organ Donation: Ethical Perspectives and Implications for Policy. Front Pediatr . 2015; 3: 100.
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Lectures by Puxun Tian
| When | Session | Talk Title | Room |
|---|---|---|---|
|
Sat-20 17:00 - 18:30 |
Kidney Posters | Clinical research of kidney transplantation from cardiac death pediatric donors | Hall 5FG-Level 5 |
|
Sat-20 17:00 - 18:30 |
Kidney Posters | Clinical Investigation of kidney transplantation from cardiopulmonary resuscitation of DCD | Hall 5FG-Level 5 |