Pre-emptive renal transplantation in children and adolescents.
Forty-three out of 204 children received their first renal transplant without prior dialysis. In order to evaluate the outcome of pre-emptive transplantation, two groups were compared retrospectively. The groups consisted of 28 children who received their transplants either without prior dialysis (ND) or after a varying period of dialysis (D). They were matched by age, year of transplantation, immunosuppressive regimen, donor source, and original disease. The percentage of living related donors was 50% in each group. Patient survival was identical in both groups; one patient died in each group due to infection in the early post-transplantation period. The 5-year graft survival rates were 89% in the ND group versus 72% in the D group. The functional parameters graft function, anemia, hyperparathyroidism, hypertension, and the growth rates tended to be slightly better in the ND group than in the D group. The differences, however, were not significant. We conclude that pre-emptive transplantation is a safe procedure that shortens the period of uremia and is, therefore, recommended for children with end-stage renal failure.
Kinderklinik, Medizinische Hochschule, Hannover, Germany.
G
G
Offner
P F
PF
Hoyer
B
B
Meyer
R
R
Pichlmayr
J
J
Brodehl
D000293:Adolescent; D000328:Adult; D001827:Body Height; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000601:surgery* / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects; D010530:Peritoneal Dialysis; D006435:Renal Dialysis; D012189:Retrospective Studies; D012449:Safety; D013997:Time Factors
D003404:Creatinine