htmlOctober 26th is the day when Xiaoyuer, who has undergone kidney transplantation, came to Peking University People's Hospital for for a review. When I met Dr. Wang Qiang, whom he admired the most, in the outpatient clinic, Xiao Yuer smiled happily.
"He recovered very well, his urine protein turned negative, and his creatinine met the standard early. Today is 39ummol/L (usually more than 70 is abnormal). Not only has he grown two centimeters tall, he is also much cheerful, he eats deliciously, and he is fat. He can enjoy the same childhood as a normal child."
Seeing that Xiaoyuer recovers as scheduled, Wang Qiang, deputy director of urology, was very happy. "Re-examination of kidney transplantation is very critical. In the parallel mode of the hospital's epidemic prevention and control and medical treatment, it is really rare for children to undergo a follow-up examination as scheduled without affecting further rehabilitation and treatment."
. When I saw Xiao Yuer's condition more than half a year ago, Dr. Wang Qiang still remembers it freshly -
6-year-old diagnosed uremia , and relied on dialysis to prolong life
9, Xiao Yuer, who is already 9 years old, has a height and weight significantly lower than his peers. He is weak and looks at most 7 years old.
At the age of 6 and a half, Xiaoyuer was diagnosed with chronic renal failure and uremia. After examination, it was caused by a gene mutation.
"The child always said he was tired, his face was not very good, and his food was not good. We always thought it was because he was picky about food. When the doctor asked when we arrived at the hospital, we noticed that the child's urine was particularly light and there was foam."
mother recalled.
did not expect this test. In addition to anemia , serum creatinine is very high, urine protein 3 "+"...
series of indicators show that Xiaoyuer has reached the stage of uremia.
"The kidney is an excretion organ, and its main function is to excrete toxic substances in the body." Director of Urology Xu Tao said: Uremia means that the kidneys of the little fish have lost the function of filtering and excretion, which will cause toxins in the body to accumulate in the body and eventually poisoning.
At this time, kidney transplantation is the best way.
But finding the right kidney is not easy.
For this reason, the family chose the relatively "economic and affordable" peritoneal dialysis for Xiaoyuer to maintain life. The "transparent" of
has been in three years.
regular peritoneal , although it can eliminate excessive toxins in the body, injecting peritoneal fluid into the abdominal cavity four to five times a day. This "restraint" makes him become less and less willing to go out. Xiao Yuer, who had just been in elementary school for half a year, had to drop out of school and go home to recuperate.
He has been cheerful since childhood. Because he left school, he had fewer and fewer languages with children of the same age, and became taciturn.
received a "life gift" late at night, successfully matching the 7-year-old kidney
after completing the transplant matching in October 2021 and completing the registration on the national kidney transplant registration system, Xiaoyuer began to wait for the appropriate kidney source.
"my country's organ distribution system has certain policy preferences for children with uremia under the age of 18. Once it is successfully matched, the child may be given priority to obtain kidney source within several months." Wang Qiang said.
"I clearly remember that in the middle of the night, I received a call from Dr. Wang Qiang, who said that a 7-year-old child's kidney was successfully matched with Xiaoyuer." Xiaoyuer's mother said: So lucky!
The whole family simply packed up their things, picked up the little fish, and drove from Qinhuangdao to Beijing overnight.
When I arrived at Peking University People's Hospital, it was already past 8 o'clock in the morning. Considering that the family is not familiar with the hospital environment and Xiao Yuer's health, the hospital staff have been with them to assist in completing the pre-admission examination and completing the inpatient procedures.
"When I met Director Wang, I was very down-to-earth. He explained it very carefully and was not anxious. I felt even more down-to-earth when I saw the clean ward and considerate medical staff." Xiao Yuer's mother said.
Deputy Director Wang Qiang explained in detail the precautions for admission to the hospital for examination
In order to complete the continuation of this life with high quality, the day before the operation, Xu Tao, director of urology, organized a general round, discussed and evaluated the risk of surgery, and formulated detailed surgery, treatment plans and nursing plans; anesthesiologists and operating room nurses are ready for adequate surgical preparations...
All of this is to ensure the safety of Xiaoyu'er's life.
raced against time, 6 hours, 1800 kilometers of life relay
At the same time, at 1 a.m., Dr. Wang also received a call from Deputy Director Wang Qiang. He immediately booked the earliest flight, set off from home at 5 o'clock, and rushed to the airport to Dalian.
He shoulders an important task - to retrieve the kidney source for the little fish.
"All the way, we have been racing against time."
Dr. Wang rushed to Dalian Airport with a special transport ice bucket, and the China Southern Airlines staff who received the news specially arranged the bridge for him to get off the plane as the first passenger; the doctor of the Second Affiliated Hospital of Dalian Medical University "distantly" sent the donated organs; on the return trip, Air China staff assisted the green channel throughout the journey...
from the hospital dispatch, the airline "green channel", and the road drivers cooperated highly. Every link is to ensure that the donated organs are delivered as soon as possible at a faster speed.
1800 kilometers round and back, and the
, who is responsible for transporting the organs of "life", Dr. Wang is running non-stop on the road. When he arrived at Capital Airport, the clock pointed to 2:42 pm.
. It is still nearly 30 kilometers away from Capital Airport to Peking University People's Hospital. You need to pass through the airport expressway, North Second Ring and West Second Ring .
Hospital staff immediately contacted Beijing Traffic Broadcast . With the prompts from the host of the live broadcast room 103.9 and the support of the driver, the ambulance arrived at the hospital smoothly at 3:14 pm.
Doctor Wang trotted all the way and breathed a sigh of relief when he handed over the organ to the doctor who was about to enter the operating room as soon as possible.
"I was basically running throughout the journey. It is very important for the patient to complete the organ transplant in the shortest time."
html took 16 hours, traveling back and forth nearly 1,800 kilometers, carrying an ice bucket weighing more than 5 kilograms. When he completed the task, his blue T-shirt was covered with sweat stains.6 hours, and the sweat stains left obvious traces on Dr. Wang's
T-shirt
Multi-disciplinary cooperation, life continues Xiaoyuer returns to the ward
At this time, the little fisher was already lying on the transfer truck and was pushed to the operating room.
. Dr. Wang Qiang came to the operating room early, and he needed to complete a very important step ahead of time - kidney repair.
"Kidney repair" is to clean the donated kidneys. The purpose is to remove excess fat tissue, and to trim blood vessels and ureters to maintain a certain length and a certain diameter, which is conducive to the axial, and then transplant it into the body of the little fish.
The surgeon Wang Qiang said: But whether it is the pruning process or the transplantation process, every step must be meticulous and serious, and there is no tolerance for any mistakes.
During the process of "repair of kidney", Zhang Xiaopeng, chief physician of urology, led his assistant to make a small arc-shaped incision in the lower right abdomen of the little fish who "slept" on the operating table, gently separated, pushed open, and ligated to layer by layer, fully freeing and exposing the internal iliac artery and external iliac vein of the right iliac fossa, laying a solid foundation for the next transplantation of vascular anastomosis of . At the same time, the operating room anesthesiologists and nurses cooperated in an orderly and skillfully.
Everyone knows that whether the transplant is successful or not requires multiple "levels", and the first level is the surgical level.
surgical photo, right 3 is the surgeon Wang Qiang
children's kidneys, which are small in themselves and have higher requirements for the anastomosis technology of blood vessels and ureters.
Under the strong protection of anesthesia department, Dr. Wang Qiang carefully "sends" the donor's "fresh" kidney into the right iliac fossa, and then end-end anastomosis of the donor's kidney artery with the Xiaoyu's internal iliac artery, and anastomosis of the kidney vein with the external iliac vein.
"Anastomosis is completed, but it is not over. There is another important step - the anastomosis oral blood leakage test."Doctor Wang Qiang said: At this time, we need to release the blood vessels that temporarily block the blood flow, and check that there is no blood leakage or bleeding in the arteriovenous mouth, so that the blood flow will be completely released, and we dare not relax at all at all.
The pink and tender "fresh" kidney transplanted into the body of Xiaoyuer
What is gratifying is that after the resumption of kidney blood flow, the "new" kidneys quickly began to become hard, rosy in color, and the blood vessels were pulsating strongly. "In-home" started working in just a few minutes, and clear urine flowed into the urine bag drop by drop from the urethra.
operation was very smooth, and Xiaoyuer returned to the ward.
new kidney was running well. It was discharged from the hospital after 12 days of transplantation. The successful surgery did not mean success. While closely monitoring the changes in blood pressure and urine volume, in addition to avoiding the occurrence of various complications such as postoperative bleeding and thrombosis, the acute rejection response acceleration period must be strictly controlled on the seventh day of postoperative day. 8 hours after
, Xiaoyuer's urine volume reached 5200ml, and the blood creatinine value dropped to 200 ummol/L, then 149, 118, 86, 31...
12 days after the transplant, under the careful care of the urology nursing team, Xiaoyuer recovered well and was ready to be discharged from the hospital.
Urology nursing team carefully took care of
Watching the child's condition improve little by little, Xiaoyuer's mother's mother finally put down the big stone in her heart. She was not good at talking and tears in her eyes, and left gratitude before leaving:
"
During the hospitalization, Director Wang always came to see him, changed the medicine himself, and found an opportunity to chat with the child to encourage him. It is our blessing to meet such a good doctor and medical team. Thanks to Peking University People's Hospital for giving the child a second life.
”
Picture: 12 days after the operation, Xiaoyuer was discharged from the hospital.
Internal and external linkage, "follow-up" helps the patient get continuous systematic treatment
Just removed the peritoneal dialysis tube that he had been with for many years last week, and Xiaoyuer, who has recovered from his "free body", was much more relaxed and cheerful.
"Uncle Wang said that I can go to school after another half a year of rest. "The light of hope flashed in Xiaoyuer's eyes.
When I learned that the urology transplant team and pediatric nephrology experts jointly established a follow-up group to form a multi-disciplinary closed-loop management for children with kidney transplants. From before transplant to after transplant, the children can receive comprehensive professional guidance and accurate evaluation. At the same time, the follow-up was assisted with abdominal ultrasound, blood creatinine, virus detection, blood drug concentration and other examinations, immune status assessment, growth and development status, etc., and timely adjust the treatment plan.
Xiaoyuer's mother was so happy that she couldn't stop talking: "It is our greatest luck to meet the expert team of Peking University People's Hospital. "
Experts remind
According to the 2012 Chinese epidemiological survey , there are about 130 million chronic kidney disease patients in my country. It is worth noting that there are more than 2 million children with kidney disease in my country. chronic kidney failure is increasing at a rate of 13% per year.
Children with kidney failure are the first choice for kidney transplantation, the earlier the effect, the better!
experts remind that urine examination is an effective means to detect kidney diseases in the early stage. When unexplained fatigue, anemia, decreased appetite, foam urine, etc. occur, you should seek medical treatment as soon as possible.
children with uremia are the first choice for kidney transplantation. Because of its congenital nature and Hereditary nephropathy accounts for a large proportion, and generally conservative treatment is powerless with medication. The earlier you receive kidney transplant, the better the long-term effect.
Children's kidney transplant surgery, the small incision, and no need to remove the original kidney without special reasons. As the new kidney replaces the old kidney, the child's donor kidney will grow on its own, and the old kidney will atrophy, thereby promoting the growth and development of the child. However, it should be noted that immunity after transplantation decreases, so it is very important to prevent infection and regular follow-up.
must be followed up regularly. When you come to the hospital for re-examination,
kidney transplant is different from other organ transplants. It is very "delicate", and the rejection reaction is second only to the skin, and the danger is much greater than that of liver transplantation. Through drug concentration detection, the safe dose of the drug is ensured, so that the patient will not have rejection reactions, and can avoid adverse drug reactions.
patients with kidney transplantation need to take anti-rejection drugs for life. The purpose of long-term follow-up is to prevent the occurrence of rejection, prevent infection, observe growth and development. The interval of regular review of
is closely related to the time of kidney transplantation. Experts suggest that you usually need to come to the hospital for re-examination within 2-3 months after transplantation, once every two weeks for more than 3 months, and continue to be smoothly changed to once a month, which can be appropriately extended after one year.
But it must be emphasized that once fever, oliguria, swelling and pain in the kidney area occur, come to the hospital for treatment in time.
People's Hospital of Peking University explores
A new model for epidemic prevention and control and medical treatment interconnection
with responsibility and responsibility
Written by "People's Hospital for the People"
Written by the heartwarming answer sheet of
Contributed by Propaganda Center and Urology
Reported by Zhong Yanyu
Photography | Zhong Yanyu, Zirui
Editor | Cosine, Shi Yu
Declaration | If reprinted, please indicate the source "Peking University People's Hospital" (WeChat ID: rmyy 1918)
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