Korean J Urol.
1995 May;36(5):549-555.
Clinical Review of Renal Transplantation in Children
- Affiliations
-
- 1Department of Urology, and Institute for Medical Science, Keimyung University, School of Medicine, Taegu, Korea.
- 2Department of Surgery, and Institute for Medical Science, Keimyung University, School of Medicine, Taegu, Korea.
- 3Department of Internal Medicin, and Institute for Medical Science, Keimyung University, School of Medicine, Taegu, Korea.
Abstract
- We studied retrospectively 17 patients(<19 years old), who received living-donor renal transplantation between Nov. 1982 and May. 1994. Recipients were composed of 10 males and 7 females, with mean age of 16.5 years old(range: 7-19). The causes of renal failure were chronic glomerulonephritis in 6 patients(2 focal segmental glomerulosclerosis, 2 IgA nephropathy, 1 membranoproliferative glomerulonephritis, 1 nephrotic syndrome), urinary tract anomalies in 2 patients(vesicoureteral reflux and anterior urethral valve in each) and unknown cause in 9 patients. The incidence of urologic anomalies in children was more frequent than adult. Immunosuppression after transplantation was with cyclosporine-A and prednisolone in all patients. Acute rejection occurred in 4 patients, who were recovered after steroid pulse therapy. One patient lost the graft because of chronic rejection. Postoperative complications were 2 perirenal hematoma, 2 bacterial urinary tract infection, 2 avascular necrosis of hip joint, 1 cytomegalovirus(CMV') pneumonia, 1 miliary tuberculosis, and 1 hirsuitism. There were 2 deaths, and the causes of death were CMV pneumonia and pulmonary edema. The results of renal transplantation in children were not satisfactory in comparison to those achieved in adults. Although successful renal transplantation in children with end stage renal disease appears to permit the maximal opportunity for growth and development, some problems such as dosage of immunosuppressants, fluid and electrolyte balance, nutritional support remain a persistent obstacle to long term survival. So more research to these problems will be necessary to improve of graft salvage and survival in children.
Keyword
MeSH Terms
-
Adult
Cause of Death
Child*
Female
Glomerulonephritis
Glomerulonephritis, IGA
Glomerulonephritis, Membranoproliferative
Glomerulosclerosis, Focal Segmental
Growth and Development
Hematoma
Hip Joint
Humans
Immunosuppression
Immunosuppressive Agents
Incidence
Kidney Failure, Chronic
Kidney Transplantation*
Male
Necrosis
Nutritional Support
Pneumonia
Postoperative Complications
Prednisolone
Pulmonary Edema
Renal Insufficiency
Retrospective Studies
Transplants
Tuberculosis, Miliary
Urinary Tract
Urinary Tract Infections
Water-Electrolyte Balance
Immunosuppressive Agents
Prednisolone
