关键词: 儿童, 肾移植, 预后, 多学科管理

Abstract: Ｏｂｊｅｃｔｉｖｅ：To explore the effect of multidisciplinary management on pediatric renal transplantation,especially the role of preoperative and postoperative management in improving  prognosis of pediatric renal transplantation.
Ｍｅｔｈｏｄｏｌｏｇｙ：Clinical data of children who underwent renal transplantation using organ donations between January 2011 to May 2019 were retrospectively analyzed.All of the recipients underwent multidisciplinary preoperative and postoperative management.Multidisciplinary management program includes:pretransplantation evaluation,management and preparation were performed at our institution; perioperative treatments were performed at organ transplant centers cooperated with us; and  both pediatric nephrologist and transplant surgeon are responsible for the posttransplantation manage ment of the recipients.
Ｒｅｓｕｌｔｓ：①One hundred and twenty nine pediatric patients underwent renal transplantation in our unit.The mean age of  recipients was 106±38 years,the minimum recipient age was 21 month,and the minimum recipient weight was 9kg.②86% of  recipients were ascertained definite diagnosis of primary disease of ESRD,and among them,congenital anomalies of the kidney and urinary tract and inherited renal disease were the major causes of ESRD.Prior to the transplantation,the majority of the recipients were on dialysis (96％),and the median dialysis time was 13(0720) years.Anemia control rate was 70％,serum calcium control rate was 77％,phosphorus control rate was 65％,iPTH control rate was 66％ and severe LVH control rate was 80％.③Postoperative management:The median duration of followup  was 20 (1148) years.During the followup period,the infection rate was 48％, bacteria  was the most frequent causative organisms; the incidence of rejection was 108％.④The  mean eGFR was 812±298(ml/min/173m2) at the last follow up.Patient survival at 1,3,5 and 7 years was 966％.Graft survival at 1,3,5 and 7 years was 87％.Sixteen cases experienced graft loss,and most of them were occurred in the first month after transplantation.Ｃｏｎｃｌｕｓｉｏｎ：The longterm outcome of pediatric renal transplantation was very well based on the multidisciplinary management approach.This approach is a wellestablished experience and worthy promoting.