Transplantacija dečjih bubrega – hirurška tehnika en bloc i varijacija pozicije transplantata

  • Vladan M Popović Klinika za vaskularnu i transplantacionu hirurgiju KCV
  • Vuk D Sekulić Clinic for Urology, Clinical Center of Vojvodina, Novi Sad, Serbia
  • Vladimir Č Manojlović Clinic for Vascular and Transplantation Surgery, Clinical Center of Vojvodina, Novi Sad, Serbia
  • Đorđe P Milošević Clinic for Vascular and Transplantation Surgery, Clinical Center of Vojvodina, Novi Sad, Serbia
  • Dragan S Nikolić Clinic for Vascular and Transplantation Surgery, Clinical Center of Vojvodina, Novi Sad, Serbia
  • Janko J Pasternak Clinic for Vascular and Transplantation Surgery, Clinical Center of Vojvodina, Novi Sad, Serbia
DOI: https://doi.org/10.2298/6918

Sažetak


Uvod. Zbog uvek prisutnog nedostatka graftova za transplantaciju bubrega, sve se više prihvataju organi iz grupe takozvanih „marginalnih donora“. Ovo je grupa koja može da obezbedi optimalni efekat transplantacije, u zavisnosti od karakteristike organa i/ili tehnike implantacije. Prikaz slučaja. Pokazali smo uspešnu varijaciju pozicije para bubrega i modifikovanog pristupa transplantacije bubrega od deteta odrasloj ženskoj osobi. Ureteralna anastomoza rađena je bez antirefluksne procedure i to nije dovelo do razvoja refluksne bolesti u ranoj fazi. Postoperativni tok protekao je uredno. Zaključak. Položaj para bubrega pokazao se kao zadovoljavajući i pored rasta bubrega do očekivanih razmera i relativno male karlice. Nije bilo nikakvih problema sa venskom stazom i funkcijom bubrega.

 

 Ključne reči:

transplantacija bubrega; deca; odrasle osobe; hirurgija, operativne procedure; postoperativni period.

Biografije autora

Vladan M Popović, Klinika za vaskularnu i transplantacionu hirurgiju KCV
ass.dr
Dragan S Nikolić, Clinic for Vascular and Transplantation Surgery, Clinical Center of Vojvodina, Novi Sad, Serbia
Doc.dr
Janko J Pasternak, Clinic for Vascular and Transplantation Surgery, Clinical Center of Vojvodina, Novi Sad, Serbia
Prof.dr

Reference

Merkel FK, Matalon TA, Brunner MC, Patel SK, Zahid M, Ahmad N, et al. Is en bloc transplantation of small pediatric kidneys into adult recipients justified? Transplant Proc 1994; 26(1): 32−3.

Ojo AO, Hanson JA, Meier-Kriesche H, Okechukwu CN, Wolfe RA, Leichtman AB, et al. Survival in recipients of marginal cadaveric donor kidneys compared with other recipients and wait-listed transplant candidates. J Am Soc Nephrol 2001; 12(3): 589−97.

Meakins JL, Smith EJ, Alexander JW. En bloc transplantation of both kidneys from pediatric donors into adult patients. Surgery 1972; 71(1): 72−5.

Amante AJ, Kahan BD. En Bloc Transplantation of kidneys from pediatric donors. J Urol 1996; 155(3): 852−7.

Satterthwaite R, Aswad S, Sunga V, Shidban H, Mendez RG, Bo-gaard T, et al. Outcome of en bloc and single kidney transplan-tation from very young cadaveric donors. Transplantation 1997; 63(10): 1405−10.

Bresnahan BA, McBride MA, Cherikh WS, Hariharan S. Risk factors for renal allograft survival from pediatric cadaver do-nors: an analysis of united network for organ sharing data. Transplantation 2001; 72(2): 256−61.

Dharnidharka VR, Stevens G, Howard RJ. En-Bloc Kidney Transplantation in the United States: An Analysis of United Network of Organ Sharing (UNOS) Data from 1987 to 2003. Am J Transplant 2005; 5(6): 1513−7.

Satterthwaite R, Aswad S, Sunga V, Shidban H, Mendez RG, Bo-gaard T, et al. Outcome of en bloc and single kidney transplan-tation from very young cadaveric donors. Transplantation 1997; 63(10): 1405−10.

Remuzri G, Grinyo J, Ruggenetti P, Bevtini M, Cole EH, Milford EL, et al. Early erpericnce wilh dual kidney transplanwtion in adults uing expanded donor criteria. J Am Soc Nephrol 1999; 10(2): 2591−8.

Andrés A, Morales JM, Herrero JC, Praga M, Morales E, Hernández E, et al. Double versus single renal allografts from aged donors. Transplantation 2000; 69(10): 2060−6.

Taal MW, Tilney NL, Brenner BM, Mackenzie HS. Renal mass: An important determinant of late allograft outcome. Trans-plant Rev 1998; 12(2): 74−84.

Sánchez-Fructuoso AI, Prats D, Marques M, Pérez-Contín MJ, Fernández-Pérez C, Contreras E, et al. Does renal mass exert an independent effect on the determinants of antigen-dependent injury. Transplantation 2001; 71(3): 381−6.

Johnson LB, Kuo PC, Dafoe DC, Schweitzer EJ, Alfrey EJ, Klassen DK, et al. Double adult renal allografts: A technique for expansion of the cadaveric kidney donor pool. Surgery 1996; 120(4): 580−4.

Borboroglu PG, Foster CE, Philosophe B, Farney AC, Colonna JO, Schweitzer EJ, et al. Solitary renal allografts from pediatric ca-daver donors less than 2 years of age transplanted into adult recipients. Transplantation 2004; 77(5): 698−702.

Satterthwaite R, Aswad S, Sunga V, Shidban H, Mendez RG, Bo-gaard T, et al. Outcome of en bloc and single kidney transplan-tation from very young cadaveric donors. Transplantation 1997; 63(10): 1405−10.

Lu Ad, Carter JT, Weinstein RJ, Prapeng W, Salvatierra O, Dafoe dC, et al. Excellent outcome in recipients of dual kidney transplants: a report of the first 50 dual kidney transplants at Stanford University. Arch Surg 1999; 134(9): 971– 5, discussion 975–6.

Objavljeno
2017/01/20
Broj časopisa
Vol. 72 Br. 12 (2015)
Rubrika
Prikaz bolesnika