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Abstract：
OBJECTIVE: To compare the haemorrhagic and vascular complications between paediatric and adult renal transplant recipients with a long-term follow-up.
METHODS: Between March 1976 and December 2006, in all, 1865 live-donor renal transplants were carried out. Patients were stratified according to their ages into two groups; paediatric (⩽18 years; 259) and adult (>18 years; 1606). Variables assessed included incidence, risk factors, management and sequelae of vascular and haemorrhagic complications. The effect of these complications on patient and graft survival was compared.
RESULTS: Haemorrhage requiring active intervention (percutaneous drainage or surgical exploration) was reported in seven children (2.7%) and 29 adults (1.8%), while thrombotic or stenotic complications were recorded in two children (0.77%) and 19 adults (1.18%; P < 0.05). Female gender, delayed onset of diuresis and acute tubular necrosis were significant predictors of vascular complications on univariate analysis, but none remained significant on multivariate analysis. In adults, vascular complications had a significant negative effect on mean (SD) 10-year graft survival compared to patients with no complications, at 19.8 (7.63)% vs. 55.7 (1.66)% (P = 0.01). Children who developed vascular complications had a significantly higher 5- and 10-year graft survival rate than adults (P = 0.01).
CONCLUSIONS: The incidence of vascular complications is comparable in paediatric and adult transplants. Vascular complications had a significant negative influence on graft survival in adult recipients. Children who developed vascular complications appear to tolerate its effects and have a better graft survival than have adults.
METHODS: Between March 1976 and December 2006, in all, 1865 live-donor renal transplants were carried out. Patients were stratified according to their ages into two groups; paediatric (⩽18 years; 259) and adult (>18 years; 1606). Variables assessed included incidence, risk factors, management and sequelae of vascular and haemorrhagic complications. The effect of these complications on patient and graft survival was compared.
RESULTS: Haemorrhage requiring active intervention (percutaneous drainage or surgical exploration) was reported in seven children (2.7%) and 29 adults (1.8%), while thrombotic or stenotic complications were recorded in two children (0.77%) and 19 adults (1.18%; P < 0.05). Female gender, delayed onset of diuresis and acute tubular necrosis were significant predictors of vascular complications on univariate analysis, but none remained significant on multivariate analysis. In adults, vascular complications had a significant negative effect on mean (SD) 10-year graft survival compared to patients with no complications, at 19.8 (7.63)% vs. 55.7 (1.66)% (P = 0.01). Children who developed vascular complications had a significantly higher 5- and 10-year graft survival rate than adults (P = 0.01).
CONCLUSIONS: The incidence of vascular complications is comparable in paediatric and adult transplants. Vascular complications had a significant negative influence on graft survival in adult recipients. Children who developed vascular complications appear to tolerate its effects and have a better graft survival than have adults.
摘要：
目的：通过长期随访，比较儿科和成人肾移植受者的出血和血管并发症。
方法：从1976年3月到2006年12月，1865年进行了活体肾移植。根据患者的年龄将其分层为两组;儿科（18岁;259）和成人（>18岁;1606）。评估的变量包括发病率，危险因素，血管和出血性并发症的处理和后遗症。比较了这些并发症对患者和移植物存活的影响。
结果：据报道，7名儿童（2.7%）和29名成人（1.8%）发生了需要积极干预（经皮引流或手术探查）的出血，2名儿童(0.77%)和19名成人(1.18%;P<0.05)发生血栓或狭窄并发症。女性性别,单因素分析显示，延迟发作的利尿和急性肾小管坏死是血管并发症的重要预测因素，但在多变量分析中没有一个仍然重要。在成年人中,与没有并发症的患者相比，血管并发症对平均10年移植物存活率有显著的负面影响，在19.8（7.63）％与55.7(1.66)%(P=0.01)。发生血管并发症的儿童的5年和10年移植物生存率明显高于成人（P=0.01）。
结论：儿科和成人移植中血管并发症的发生率相当。血管并发症对成人受体的移植物存活有显著的负面影响。发生血管并发症的儿童似乎可以忍受其影响，并且比成年人有更好的移植物存活率。
方法：从1976年3月到2006年12月，1865年进行了活体肾移植。根据患者的年龄将其分层为两组;儿科（
结果：据报道，7名儿童（2.7%）和29名成人（1.8%）发生了需要积极干预（经皮引流或手术探查）的出血，2名儿童(0.77%)和19名成人(1.18%;P<0.05)发生血栓或狭窄并发症。女性性别,单因素分析显示，延迟发作的利尿和急性肾小管坏死是血管并发症的重要预测因素，但在多变量分析中没有一个仍然重要。在成年人中,与没有并发症的患者相比，血管并发症对平均10年移植物存活率有显著的负面影响，在19.8（7.63）％与55.7(1.66)%(P=0.01)。发生血管并发症的儿童的5年和10年移植物生存率明显高于成人（P=0.01）。
结论：儿科和成人移植中血管并发症的发生率相当。血管并发症对成人受体的移植物存活有显著的负面影响。发生血管并发症的儿童似乎可以忍受其影响，并且比成年人有更好的移植物存活率。
