国立成育医療研究センターにおける腎移植の適応と成績

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  • Kidney transplantation at National Center for Child Health and Development

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We report on our experience in kidney transplantations (KTs) in our center during the past 10 years (2002-2012). Forty KTs were performed for 39 recipients: 33 donors were live; 6 were nonheart beating; and 1 was brain-dead. The median age of donors was 43 (minimum 20-maximum 67). Donation procedures for the live donors had been open nephrectomy until 2009; they have been hand-assisted laparoscopic nephrectomy since 2010. Median recipient age was 9.5 (min. 2-max. 30), and the indications of KT included congenital anomalies of kidney and urinary tracts in 11, nephronophthisis in 6, focal segmental glomerulosclerosis in 5, and so on. ABO-incompatible KTs were performed on 8 recipients. Recipient procedures were performed by retroperitoneal approach, except for 8 recipients who had a laparotomy with vascular anastomoses to the abdominal aorta and inferior vena cava. Ureteral anastomoses were performed by extravesicular ureteral implantations except for 2 recipients. Twenty-two recipients (55%) developed infectious complications after KTs, which included cytomegalovirus infection, Ebstein-Barr infection, urinary tract infection, and 12 (30%) developed acute rejection. Surgical complications included urinary leakage from the anastomosis, vesicoureteral reflux to the graft, and intestinal obstruction. Four grafts were lost, including one patient death with a functioning graft. Nine-year graft survival was 88.5%.

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  • 移植

    移植 49 (1), 055-064, 2014

    一般社団法人 日本移植学会

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