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  • Title: Renal transplantation in children.
    Author: Samhan M, Fathi T, Al-Kandari N, Buresley S, Nampoory MR, Nair P, Halim M, Al-Mousawi M.
    Journal: Transplant Proc; 2007 May; 39(4):911-3. PubMed ID: 17524848.
    Abstract:
    OBJECTIVE: Renal transplantation is the preferred method for the treatment of children in end-stage renal disease (ESRD). In this retrospective study, we analyzed the results at our center. PATIENTS AND METHODS: Between November 1993 and June 2006, 86 children (50 boys and 36 girls) received organs from 50 living donors (LDTx) and 36 cadaveric donors (CDTx). Twenty children were <10 years. In addition to ESRD, some patients had one or more other high-risk factors, eg, abnormal lower urinary tract in 36 recipients (42%). The procedure was a preemptive transplantation in 28, and a retransplantation in 9 recipients. Induction immunosuppression used either antithymocyte globulin (43 cases) or anti-interleukin-2 receptor antibodies (20 cases). RESULTS: Patients were followed for 6 to 150 months. There were 24 surgical complications (28%), 26 acute rejection episodes (33%), and 17 of systemic bacterial or viral infections. Two recipients died at 1 and 21 months. The 14 grafts were lost at 1 day to 87 months. The 1- and 10-year actuarial survival rates were 99% and 98%, respectively, for the recipients, and 88% and 84%, respectively, for the grafts. The 10-year actuarial graft survival rates were 98% in LDTx and 64% in CDTx; 86% in recipients >10 years old and 75% in recipients <10 years old. Abnormal urinary tract, pretransplantation dialysis, and transplant number showed no effect on graft survival. All pediatric recipients with functioning grafts are fully rehabilitated. CONCLUSION: Renal transplantation is the preferred method of treatment for children in ESRD. Higher graft survival rates were achieved in older children and following LDTx.
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