Long-term follow up of renal function and histology after renal allograft transplantation in early childhood.
Survival rates, renal function, and histopathology were evaluated in 49 prospectively followed patients transplanted under 5 years of age at our center. Most patients (84%) suffered from congenital nephrosis of the Finnish type. Triple immunosuppression with cyclosporine administered in three daily doses to pre-school children was used. Patient survival 7 years after transplantation was 98% and graft survival 88%. All graft losses were due to post-transplantation nephrosis. The proportion of pathological findings in the follow-up biopsies did not change substantially with time. Five years after transplantation, 47% showed a normal histology and after 7 years this rose to 67%. Mean glomerular filtration rate (GFR) was 68 and 55 ml min per 1.73 m2 5 years and 7 years, respectively, after transplantation. The decline in GFR with time was significant. We conclude that good long-term results can be achieved with individually tailored triple immunosuppression in the youngest age group, even with cadaveric donors.
Hospital for Children and Adolescents, Pediatric Nephrology and Transplantation, University of Helsinki, Finland.
E
E
Qvist
L
L
Krogerus
J
J
Laine
H
H
Jalanko
K
K
Rönnholm
K
K
Salmela
H
H
Sairanen
M
M
Leijala
C
C
Holmberg
D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation / Q000401:mortality / Q000473:pathology / Q000502:physiology; D008297:Male; D011446:Prospective Studies; D015996:Survival Rate; D013997:Time Factors