Korean J Nephrol.  1998 Jan;17(1):116-123.

Analysis of Risk Factors Affecting the Pediatric Renal Allograft Survival in Cyclosporine Era

• Kim PK
• Choi WK
• Kim JH
• Kim MS
• Choi JW
• Kim YS
• Kim SI
• Park KI

Abstract

A total of 82 pediatric renal transplants treated with cyclosporine and low dose prednisolone as the main immunosuppressive agents were used as the subjects of this study to find the risk factors whitch might influence the pediatric renal allograft survival in a single center from Feb. 1984 to Mar. 1996. The mean age of the recipients was 14.7 years ranging from ages 3.9 to 19.9. There were 19 cases of graft loss, and 3 recipient death. The major causes of the graft loss were acute and/or chronic rejection, poor compliance and patient's death. The 1-, 3- and 5-year graft survival were 94.9%, 86.2% and 70.7% respectively. The original renal deseases of ESRD were FSGS (14 cases), chronic pyelonephropathy and VUR (11 cases) and IgA nephropathy (8 cases) in order frequency. The significant risk factors for the outcome were the ABO incompatibility (ABO identical 89.6% vs compatible 26.9%, P=0.001) and development of more than 1 episode of acute rejection within 1 year (P=0.002) and after 1 year (P=0.004). Other factors such as recipient's age, donor-recipient relationship and type and duration of dialysis modalities before trasplantation (P>0.05). In conclusion, for the successful outcome of pediatric renal transplantation, strict ABO matching and development and application of more effective immunosuppressive agents such as mycophenolate or FK- 506 to combat the acute and/or chronic rejection is required in near future.

Keyword

Pediatric; Renal transplantation; Graft survival; Risk factors

MeSH Terms

Allografts*
Compliance
Cyclosporine*
Dialysis
Glomerulonephritis, IGA
Graft Survival
Immunosuppressive Agents
Kidney Failure, Chronic
Kidney Transplantation
Prednisolone
Risk Factors*
Transplants
Cyclosporine
Immunosuppressive Agents
Prednisolone