End-stage renal failure in children younger than 6 years: renal transplantation is the therapy of choice

European Journal of Pediatrics
U VesterJ Brodehl

Abstract

Between 1975 and 1994, 46 children under 6 years of age received a total of 52 renal transplants. Obstructive uropathy and dysplasia accounted for most causes of terminal renal failure (17 and 12 cases respectively). Four patients required a second, 1 patient a third transplantation. Cadaveric organs were used on 33 occasions; 19 patients received a living-related donor kidney. Immunosuppression was performed with azathioprine in 5, with cyclosporine A in 21 and combined azathioprine/cyclosporine therapy in 20 cases. After 1 year, graft survival was 81%, and after 5 years 78%. Creatinine clearance declined slightly between 1 and 5 years from 69 to 56 ml/min per 1.73 m2. Main causes of graft failure were thrombotic complications in 6 cases and death with functioning graft in 5 cases. Graft thrombosis occurred only in grafts from young donors under the age of 7 years and after vascular anastomosis to the iliac vessels. Only two transplants were lost in rejection episodes. Patient survival was 94% after 1 and 90% after 5 years. Two patients died due to septiacemia, 1 died of a ruptured aortic aneurysm, 1 of cerebral ischaemia and 1 suddenly of unknown cause. Patient and graft survival was not different compared with 204 patients a...Continue Reading

Citations

Dec 31, 2005·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Guido F LaubeThomas J Neuhaus
Sep 25, 2002·Transplantation Proceedings·S S JoshiN Goel
Mar 20, 1999·Transplantation Proceedings·J FangmannG Offner
Aug 26, 2011·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Anneke KramerKitty J Jager
Dec 8, 2009·Clinical Journal of the American Society of Nephrology : CJASN·Mirja WedekinLars Pape
Apr 11, 2008·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Mark G MeisterStephen D Marks
Mar 17, 2007·Transplantation Proceedings·C D GarciaV D Garcia
Jan 31, 2006·Transplant International : Official Journal of the European Society for Organ Transplantation·Thomas BeckerGisela Offner
Jun 6, 2009·Pediatric Transplantation·P J GoldsmithN Ahmad
Nov 15, 2013·Clinical Transplantation·Susan C PittJason R Wellen
Jan 9, 2004·Pediatric Clinics of North America·Mark R Benfield
Jan 3, 2018·Clinical Transplantation·Andrew M RizziYee Lu
Oct 14, 2006·Current Opinion in Urology·M M El-Mekresh

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