Pediatric renal transplantation with an emphasis on the prognosis of patients with chronic renal insufficiency since infancy.
In this report recent experience with renal transplantation in 43 children who were 17 days to 16 years old was reviewed. One-year patient survival rate was 98%, and overall one-year graft survival rate was 68%. One-year graft survival rate was 73% for cyclosporine-treated patients and 78% for recipients of related donor kidneys. A subpopulation of patients affected with renal insufficiency since infancy was analyzed separately to evaluate the prognosis of these patients, who have previously been reported to be a high risk for permanent neurologic, developmental, and growth retardation. All 16 such patients underwent transplantation. Gross motor delay that was noted in 31% of patients before surgery resolved in all patients after transplantation. No evidence of severe developmental delay was noted after transplant and seven of 11 patients with successful transplants had evidence of catch-up growth. Overall renal transplantation is a safe and effective procedure for children with renal failure, and even the patients at highest risk for growth and developmental failure caused by renal insufficiency show potential for rehabilitation after transplantation.
Tagge
E P
EP
Department of Surgery, University of Michigan Medical Center, Ann Arbor 48109-0331.
Campbell
D A
DA
Dafoe
D C
DC
Merion
R M
RM
Sedman
A B
AB
Kelsch
R C
RC
Mollen
E
E
Rocher
L L
LL
Turcotte
J G
JG
D000293:Adolescent; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003524:Cyclosporins / Q000627:therapeutic use; D005260:Female; D006085:Graft Survival; D006128:Growth; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D011379:Prognosis; D013997:Time Factors; D014019:Tissue Donors
D003524:Cyclosporins