ABSTRACT
During the last 14 years, since the opening of the Center for Childrens' Hemodialysis the University Children's Hospital of Belgrade, 174 children with terminal renal failure were treated by chronic hemodialysis. Of these, only 35 patients (20.1%), 14 girls and 21 boys, mean age 12.6 +/- 4.9 years, were transplanted. The average waiting time for transplantation was 24.6 months (range 0-120 months). Twenty-five patients were transplanted with paternal kidney, the others were cadaveric transplantations. More than half of transplantations were done abroad. Of 35 patients, 20 were under follow-up for over 6 months (45.7 +/- 7.2 range 6 to 102 months). Five year patient survival was 94.1% and the graft survival over the same period was 76.4%. 45.7 +/- 7.2 months after transplantation the outcome was the following: 11 patients (55%) had GFR over 60 ml/min/1.73 m2, 5 patients (25%) had GFR from 25 to 60 ml/min/1.73 m2, 2 patients (10%) returned to chronic hemodialysis, 1 patient was retransplanted and 1 patient died. All patients with GFR of over 60 ml/min/1.73 m2 are well psychosocially rehabilitated, 62.4% are normotensive without antihypertensive therapy, and only 9.9% are growth retarded.
Subject(s)
Kidney Transplantation , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Kidney Transplantation/mortality , Kidney Transplantation/statistics & numerical data , Male , YugoslaviaABSTRACT
Blood counts, bone marrow cytology and iron status in 13 patients with severe renal anemia assessed prior to and after recombinant human erythropoietin treatment. The mean increase of PCV after 8 weeks of treatment was 50%. Simultaneously, we observed a fourfold increase of the reticulocyte count. This increment correlated with a twofold increase of the percentage of bone marrow erythroblasts. We also observed an increment of the relative number of erythropoietin-dependent early erythroblasts. The tager PCV of 0.30 was achieved in 4 of 5 predialysis patients, but was not achieved in 8 hemodialysis patients because they had an "absolute" bone marrow erythroblastopenia. In conclusion, conventional hematologic examination revealed that application of recombinant human erythropoietin leads to improvement of erythrocytopoiesis in different stages of chronic renal failure.
Subject(s)
Anemia/blood , Anemia/therapy , Erythrocyte Count , Erythropoietin/therapeutic use , Kidney Failure, Chronic/complications , Adult , Anemia/etiology , Anemia/physiopathology , Erythropoiesis , Female , Humans , Male , Middle Aged , Recombinant Proteins/therapeutic useABSTRACT
Immunosuppression with Cyclosporine A in kidney transplantation, triple therapy (CyA + Imuran + corticosteroids) and plasmapheresis before and after kidney transplantation in high risk recipients (positive cytotoxic antibody, MLC at the level of non related persons), also in high risk patients (juvenile diabetes, patients over 50 years old). In 1988 we had done in our Centre, kidney transplantation in 52.8% (28: 53) in high and increased risk patients. Triple therapy with plasmapheresis before and after kidney transplantation (if the level of cytotoxic antibodies is over 15%) allows successful kidney transplantation in high risk kidney recipients. Patients with juvenile diabetes are also available kidney recipients with therapy and permanent regulation of blood sugar. The patients of the age group between 50-60 years should be considered as suitable for kidney transplantation.
