Clinical Experience of 27 Pediatric Renal Transplantation at a Single Center / 대한비뇨기과학회지

ABSTRACT

PURPOSE: Renal transplantation is considered the treatment of choice for children with end-stage renal disease (ESRD). The results of renal transplantation were retrospectively analyzed to assess certain aspects of pediatric renal transplantation. MATERIALS AND METHODS: Between January 1989 and January 2005, 27 pediatric kidney transplantations were carried out at our center. Fifteen (55.5%) patients underwent hemodialysis, two (7.4%) peritoneal dialysis and ten (37.0%) were conservative managed prior to treatment. Living- related donors provided 25 (92.6%) of the transplanted organs, with cadaver sources utilized for 2 (7.4%) patients. The donor age, organ source, etiology of ESRD, hospitalization period, postoperative complications, occurrence and number of acute rejections, and graft survival were assessed. RESULTS: The causes of renal failure were chronic glomerulonephritis in 10 patients [IgA 3 nephropathy, 3 membranoproliferative glomerulonephritis (MPGN), 2 nephrotic syndrome and 2 focal segmental glomerulosclerosis (FSGS)], urinary tract anomalies in 6 (4 reflux nephropathy and 2 polycystic kidney), Alport syndrome in 1, hypertensive nephropathy in 2, systemic immunological disease in 1 and unknown causes in a further 5. Acute rejection occurred in 12 patients, all of who recovered after steroid pulse therapy. Growth and development failed in 2 patients. The postoperative complications included 4 urinary tract infections, 3 retroperitoneal hematomas, 2 lymphoceles and 1 acute ureteral obstruction. Four patients expired due to post-operative complications, such as disseminated intravascular coagulation (DIC), intracranial hematoma, sepsis and renal failure. CONCLUSIONS: Pediatric renal transplantation can be successful, even in young children with ESRD.