Korean J Urol.  2007 Jan;48(1):72-76. 10.4111/kju.2007.48.1.72.

Clinical Experience of 27 Pediatric Renal Transplantation at a Single Center

• Kim KH
• Yae SJ
• Kim JS
• Kwon TG
• Chung SK

• KMID: 1915025
• DOI: http://doi.org/10.4111/kju.2007.48.1.72

Abstract

PURPOSE
Renal transplantation is considered the treatment of choice for children with end-stage renal disease (ESRD). The results of renal transplantation were retrospectively analyzed to assess certain aspects of pediatric renal transplantation.
MATERIALS AND METHODS
Between January 1989 and January 2005, 27 pediatric kidney transplantations were carried out at our center. Fifteen (55.5%) patients underwent hemodialysis, two (7.4%) peritoneal dialysis and ten (37.0%) were conservative managed prior to treatment. Living- related donors provided 25 (92.6%) of the transplanted organs, with cadaver sources utilized for 2 (7.4%) patients. The donor age, organ source, etiology of ESRD, hospitalization period, postoperative complications, occurrence and number of acute rejections, and graft survival were assessed.
RESULTS
The causes of renal failure were chronic glomerulonephritis in 10 patients [IgA 3 nephropathy, 3 membranoproliferative glomerulonephritis (MPGN), 2 nephrotic syndrome and 2 focal segmental glomerulosclerosis (FSGS)], urinary tract anomalies in 6 (4 reflux nephropathy and 2 polycystic kidney), Alport syndrome in 1, hypertensive nephropathy in 2, systemic immunological disease in 1 and unknown causes in a further 5. Acute rejection occurred in 12 patients, all of who recovered after steroid pulse therapy. Growth and development failed in 2 patients. The postoperative complications included 4 urinary tract infections, 3 retroperitoneal hematomas, 2 lymphoceles and 1 acute ureteral obstruction. Four patients expired due to post-operative complications, such as disseminated intravascular coagulation (DIC), intracranial hematoma, sepsis and renal failure.
CONCLUSIONS
Pediatric renal transplantation can be successful, even in young children with ESRD.

Keyword

Kidney transplantation; Children

MeSH Terms

Cadaver
Child
Disseminated Intravascular Coagulation
Glomerulonephritis
Glomerulonephritis, Membranoproliferative
Glomerulosclerosis, Focal Segmental
Graft Survival
Growth and Development
Hematoma
Hospitalization
Humans
Immune System Diseases
Kidney Failure, Chronic
Kidney Transplantation*
Lymphocele
Nephritis, Hereditary
Nephrotic Syndrome
Peritoneal Dialysis
Postoperative Complications
Postoperative Period
Renal Dialysis
Renal Insufficiency
Retrospective Studies
Sepsis
Tissue Donors
Ureteral Obstruction
Urinary Tract
Urinary Tract Infections

Figure

• 

  Fig. 1 (A) Graft survival, (B) Patient survival.

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