Análise de Sobrevida do Enxerto em Pacientes Pediátricos Submetidos ao Transplante Renal

Ligia Soeiro; Anna Clara de Moura Lima; Alice Pimentel Vinicius Silva; Maria Eduarda Cardoso de Araújo; Daniela Saraiva Guerra Lopes; Iracy de Oliveira Araújo; Emília Maria Danta Soeiro

Autores

Ligia Soeiro Faculdade Pernambucana de Saúde – Recife (PE), Brasil. https://orcid.org/0009-0003-6656-3068
Anna Clara de Moura Lima Faculdade Pernambucana de Saúde – Recife (PE), Brasil. https://orcid.org/0009-0002-7743-1207
Alice Pimentel Vinicius Silva Faculdade Pernambucana de Saúde – Recife (PE), Brasil. https://orcid.org/0000-0001-5998-9472
Maria Eduarda Cardoso de Araújo Instituto de Medicina Integral Professor Fernando Figueira – Recife (PE), Brasil. https://orcid.org/0000-0002-6797-2037
Daniela Saraiva Guerra Lopes Instituto de Medicina Integral Professor Fernando Figueira – Recife (PE), Brasil. https://orcid.org/0009-0005-0640-0616
Iracy de Oliveira Araújo Instituto de Medicina Integral Professor Fernando Figueira – Recife (PE), Brasil. https://orcid.org/0009-0007-5920-8366
Emília Maria Danta Soeiro Faculdade Pernambucana de Saúde – Recife (PE), Brasil | Instituto de Medicina Integral Professor Fernando Figueira – Recife (PE), Brasil | Universidade Federal de Pernambuco – Recife (PE), Brasil. https://orcid.org/0000-0002-0491-6783

Palavras-chave:

Pediatria, Transplante de Rim, Insuficiência Renal Crônica, Análise de Sobrevida

Resumo

Introdução: O transplante renal . a terapia padr.o ouro para doença renal crônica (DRC) em estágio final. Entretanto, aspectos relacionados às características do doador e do receptor, à técnica cirúrgica, ao protocolo de imunossupressão e comorbidade podem impactar a sobrevida do enxerto. Objetivos: Avaliar os fatores associados à sobrevida do enxerto em pacientes pediátricos submetidos ao transplante renal. Métodos: Estudo descritivo do tipo coorte retrospectivo que incluiu todos os pacientes de 1 a 18 anos submetidos ao transplante renal na Unidade Renal Pedi.trica do Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Recife, Brasil, de janeiro de 2017 a dezembro de 2021, com tempo m.nimo de seguimento de 10 meses, totalizando 51 pacientes. O estudo foi aprovado pelo Comitê de Ética e Pesquisa do IMIP sob o CAAE: 52023921.1.0000.5201. Resultados: A mediana de idade dos pacientes ao transplante renal foi de 12 anos (9-13), sendo 27 (52,9%) do sexo masculino e oito (15,6%) com menos de 5 anos. As principais etiologias da DRC foram as anomalias congênitas do rim e do trato urinário (n = 25; 49%). Quanto ao transplante renal, 49 (96,1%) foram de doador falecido e a mediana do tempo de seguimento foi de 32 (14-42) meses. Após o transplante, 58% da população eram hipertensos, enquanto 80,4% apresentavam dislipidemia. As taxas de sobrevida do enxerto e do paciente em 5 anos, avaliadas pela curva de Kaplan Meier, foram, respectivamente, 86,3 e 90,2%. Sete pacientes (n = 5) perderam o enxerto, sendo a causa mais frequente a trombose de veia renal. As causas não glomerulares de DRC mostraram menor sobrevida do enxerto quando comparadas .s causas glomerulares (log rank p = 0,010). Conclusão: As taxas de sobrevida do enxerto e dos pacientes em nossa casuística assemelham-se aos dados nacionais e mundiais. As causas mais frequentes de perda do enxerto foram os eventos tromboembólicos. Além disso, observamos elevada prevalência de hipertensão e dislipidemia. Esses resultados nos direcionam para estabelecer estratégias para melhorar a sobrevida nos transplantes renais pediátricos.

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