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Nineteen-year experience of paediatric renal transplantation in Singapore
Annals of the Academy of Medicine, Singapore ; : 300-309, 2009.
Article in English | WPRIM | ID: wpr-340647
ABSTRACT
<p><b>INTRODUCTION</b>Renal transplantation is the treatment of choice for children with end-stage renal failure (ESRF). The paediatric renal transplant programme in Singapore was initiated in 1989. This study aimed to examine our outcomes over the 19-year period from 1989 to 2007.</p><p><b>MATERIALS AND METHODS</b>A total of 38 renal transplants were performed at our centre. Another 4 patients with overseas transplants who returned within 3 weeks post-transplant were included. The proportion of living donor (LD) transplants was 61.9%. Structural abnormalities and glomerulopathies were the most common aetiologies comprising 33% each. Median age at transplant was 13.9 years and median waiting time was 2.2 years. LD transplant recipients were younger and had a shorter waiting time than deceased donor (DD) recipients.</p><p><b>RESULTS</b>Overall patient survival rates were 95%, 92%, 86% and 86% at 1, 5, 10 and 15 years, respectively. There were 4 deaths, of which 3 were due to infections. Graft survival rates at 1, 5, 10 and 15 years for LD and DD transplants were 100%, 89.5%, 67.3%, 67.3% and 80.8%, 56.5%, 42.2%, 28.3% respectively, and were significantly higher in LD transplants. The main cause of graft loss was rejection following non-adherence. Multivariate analysis showed male gender, late acute rejections and acute tubular necrosis as predictors of graft failure. There was a high incidence of early bacterial infections (42.9%) and cytomegalovirus disease (16.7%).</p><p><b>CONCLUSION</b>Our graft survival rates for LD transplants were comparable to North American rates, although our DD transplant rates were slightly worse, probably a reflection of the prevailing transplant policies.</p>
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: Postoperative Complications / Singapore / General Surgery / Survival Analysis / Epidemiology / Multivariate Analysis / Kidney Transplantation / Outcome Assessment, Health Care / Living Donors / Graft Survival Type of study: Prognostic study Limits: Adolescent / Child / Child, preschool / Female / Humans / Male Country/Region as subject: Asia Language: English Journal: Annals of the Academy of Medicine, Singapore Year: 2009 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Postoperative Complications / Singapore / General Surgery / Survival Analysis / Epidemiology / Multivariate Analysis / Kidney Transplantation / Outcome Assessment, Health Care / Living Donors / Graft Survival Type of study: Prognostic study Limits: Adolescent / Child / Child, preschool / Female / Humans / Male Country/Region as subject: Asia Language: English Journal: Annals of the Academy of Medicine, Singapore Year: 2009 Type: Article