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首页> 外文会议>Nihon Ishoku Gakkai >Excellent long-term outcomes of ABO-incompatible kidney transplantation in children
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Excellent long-term outcomes of ABO-incompatible kidney transplantation in children

机译：儿童肾脏移植的优秀长期结果

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Due to profound shortage of suitable deceased allografts, much effort has been made to investigate whether successful kidney transplantation is possible across the ABO blood group barrier even for pedlatric recipients. Methods: Twenty-five pediatric patients underwent ABO-incompatible living kidney transplantation. All patients received three sessions of plasmapheresis (PP) or immunoadsorption (IA) to remove the anti-A/B antibodies before transplantation. This was followed by splenectomy and a conventional quadruple drug imraunosuppressive protocol. To prevent overwhelming postsplenectomy infections, penicillin prophylaxis as well as pretransplant pneumococcal vaccine was given to all patients. Results: Of 25 patients, 12 grafts had rebound increases in their anti-A/B isoagglutinin titers within 10 days posttransplant. Moreover, 10 of 12 (83%) patients developed acute rejection with the increase of isoagglutinins. One patient lost the graft because of uncontrolled delayed hyperacute rejection, while the other nine acute rejection episodes were reversed with a standard anti-rejection therapy in combination with PP/IA. Four patients had severe bacterial infectious complications after transplantation. The actuarial 1-, 5- and 10-year graft survival rates are 96%, 91% and 91%, respectively. Conclusions: With the adequate desensitization protocol, ABO-incompatible kidney transplantation is a valid alternative even for children with end stage renal disease.
机译：由于适当死亡的同种异体移植物的深刻短缺，已经致力于调查在ABO血液组屏障中是否可以进行成功的肾移植甚至是次次婴儿接受者。方法：二十五名儿科患者接受了ABO-Indompative LiveNne移植。所有患者均接受了三次血浆疫苗（PP）或免疫吸附（IA），以在移植前除去抗A / B抗体。接下来是脾切除术和常规的四重药物IMAUnosupcutive方案。为了防止压倒性的后切除切除术感染，对所有患者给予青霉素预防和预防肺炎球菌疫苗。结果：25例患者，12例移植物在后翻转后10天内的抗A / B肌凝血素滴度增加。此外，12名（83％）患者的10个（83％）患者随着异葡萄氨酸的增加而产生急性排斥。一名患者由于不受控制的延迟的超急性排斥而失去移植物，而另外九个急性排斥事件与PP / IA的标准抗排斥疗法反转。移植后，四名患者有严重的细菌传染性并发​​症。精算1-，5年和10年的移植物存活率分别为96％，91％和91％。结论：随着足够的脱敏方案，即使对于患有末期肾病的儿童，ABO-Indompative肾移植也是一个有效的替代方案。

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