Kidney transplantation has become the routine treatment for the pediatric population suffering from end stage renal disease (ESRD). In our transplant center, the program for pediatric transplant began on January 1987, once a satisfactory experience had been acquired in adults. Up until January 2010, 1392 transplants had been accomplished; 341 of them (315 from cadaveric donors and 26 from living – related donors) in recipients being under 21 years of age (mean age 13.6 +/- 5.5 yrs). The aim of this study was to investigate the case characteristics and the longterm outcomes in this patient group. The patient survival rates at 1 year, 5 and 10 years were 98.5%, 97.2%, 94.1%, respectively. At the same time points, the graft survival rates were 94.9%, 89.8%, and 80.6%, respectively. A double-drug regimen was used before 1990; this was replaced by a triple–drug regimen including a calcineurin inhibitor in 1991. Eighty-seven (26%) grafts were lost, 54% as a result of immunological and the rest as a result of non–immunological causes; 18 recipients (5%) died during the follow-up period. Bacterial infections were the main cause of patient loss; surgical complications, immunological reasons and recurrent disease were for graft loss. As expected, long–term survival in children is better than reports in adult renal transplant recipients and many more accurately reflect transplant related mortality. Overall, these data demonstrate that pediatric kidney transplantation offers favorable graft outcomes.

Pediatric kidney transplantation: a single center experience.

SANTORI, GREGORIO;VALENTE, UMBERTO
2011-01-01

Abstract

Kidney transplantation has become the routine treatment for the pediatric population suffering from end stage renal disease (ESRD). In our transplant center, the program for pediatric transplant began on January 1987, once a satisfactory experience had been acquired in adults. Up until January 2010, 1392 transplants had been accomplished; 341 of them (315 from cadaveric donors and 26 from living – related donors) in recipients being under 21 years of age (mean age 13.6 +/- 5.5 yrs). The aim of this study was to investigate the case characteristics and the longterm outcomes in this patient group. The patient survival rates at 1 year, 5 and 10 years were 98.5%, 97.2%, 94.1%, respectively. At the same time points, the graft survival rates were 94.9%, 89.8%, and 80.6%, respectively. A double-drug regimen was used before 1990; this was replaced by a triple–drug regimen including a calcineurin inhibitor in 1991. Eighty-seven (26%) grafts were lost, 54% as a result of immunological and the rest as a result of non–immunological causes; 18 recipients (5%) died during the follow-up period. Bacterial infections were the main cause of patient loss; surgical complications, immunological reasons and recurrent disease were for graft loss. As expected, long–term survival in children is better than reports in adult renal transplant recipients and many more accurately reflect transplant related mortality. Overall, these data demonstrate that pediatric kidney transplantation offers favorable graft outcomes.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11567/260284
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