[Preemptive kidney transplantation in children--experience in UHC Zagreb]. / Preemptivna transplantacija bubrega u djece--iskustvo KBC-a Zagreb.

AIM: To discuss preemptive kidney transplantation outcomes in children with end stage kidney disease. METHODS: We present the data of patients younger than 18 years who were transplanted without previous dialysis in our Clinic. We retrospectively analyzed data available in medical health records. RESULTS: Preemptive living donor kidney transplantation was performed in 6 patients younger than 18 years. Creatinine clearance before transplantation was 9 +/- 4.15 ml/min (range = 2.7-12.3 ml/min, median = 8.5 ml/min). Currently, serum creatinine in patients with functioning graft is 139.4 +/- 60.9 micromol/l (range = 72-237 micromol/l, median = 130 micromol/l). One, three and five year graft survival was 100%. Overall graft and patient survival in the follow-up period was 83.3% and 100%, respectively. After 10 years one patient started with dialysis due to chronic graft rejection. CONCLUSION: From medical and socioeconomic point of view preemptive transplantation is optimal method for treatment of children with end-stage kidney disease. Membership in Eurotransplant should increase the number of preemptive transplantations in Croatia.

[Outcome of renal transplantation in patients with chronic virus hepatitis]. / Ishod transplantacije bubrega u bolesnika s kronicnim virusnim hepatitisom.

The objective is to present results of renal transplantation in patients with end-stage renal disease and chronic virus C/B hepatitis. We retrospectively reviewed outcome of transplantation in patients having received renal allograft from 1985 to 2009 at Zagreb University Hospital Center: graft function, graft and patient survival, hepatic function, and complications of transplantation, i.e. episodes of acute rejection, manifestation of diabetes mellitus, and proteinuria. There were 91 patients, 50 men and 41 women, mean age 40.9. Patients were previously treated with dialysis for 7.8 years, with the mean follow-up after transplantation of 7.3 years. The most frequent diagnoses of end-stage renal disease were chronic glomerulonephritis, reflux nephropathy, tubulointerstitial nephritis, renal hypoplasia/aplasia, and polycystic renal disease. Good graft function (creatinine 200 micromol/L) was recorded in 59.5% of patients. One-year, 5-year and 10-year graft survival was 93%, 64% and 39%, and 1-year, 5-year and 10-year patient survival after transplantation was 98%, 72% and 42%, respectively. Normal values of liver chemistry (AST, ALT) were found in 59.5% and elevated values in 40.5% of patients. Episodes of acute rejection occurred in 56% of patients. Proteinuria was recorded in 27%, diabetes mellitus in 18% and elevated blood pressure in 66% of patients. Patients with chronic C/B virus hepatitis having undergone renal transplantation had worse graft function and worse graft and patient survival than patients without chronic hepatitis. The most common causes of death were cardiovascular diseases, cerebrovascular diseases and cirrhosis hepatitis.