title: Renal complications following heart transplantation in children: a single-center study.
abstract: Renal dysfunction is common following heajt transplantation (Tx) in adults, but little is known in children. Thus, a retrospective chajt review was performed in children who underwent heajt Tx at the Hospital for Sick Children between April 1994 and April 1999. The inclusion criteria were: age <18 years, survival >1 year post-Tx. The Schwajtz formula was used to calculate glomerular filtration rate (GFR). Decreased GFR was defined as <80 mL/min/1.73 m2. Changes in GFR were analyzed using Repeated Measures Analysis of Variance. Forty-one eligible children were included. The mean age at Tx was 7 years (range: 1 month to 16.7 years). The mean F/UP was 33 +/- 17 months, with 32/41 patients followed for at least 24 months. The GFR was decreased in 42% pre-Tx, and in 7.3% at the last F/UP (p = 0.0001). GFR did not decline significantly with time after Tx; in fact, GFR increased in the first year and remained stable afterwards (p = 0.0002). Acute renal dysfunction (ARD) episodes were common (12/41 children). Hypertension was diagnosed in 76% of children during the first year post-Tx, but persisted in only 11 (27%). GFR improves in the majority of children following heajt Tx. ARD episodes are frequent in the post-Tx period. Hypertension is common but does not persist.
authors.affiliation: Depajtment of Paediatrics, Paediatric Academic MultiOrgan Transplant Program, The Hospital for Sick Children (HSC), University of Toronto, Toronto, M5G 1X8, Canada.
authors.forename: Véronique
authors.initials: V
authors.lastname: Phan
authors.forename: Lori J
authors.initials: LJ
authors.lastname: West
authors.forename: Derek
authors.initials: D
authors.lastname: Stephens
authors.forename: Diane
authors.initials: D
authors.lastname: Hébert
mesh_terms: D000293:Adolescent; D065095:Calcineurin Inhibitors; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000453:epidemiology; D006128:Growth / Q000502:physiology; D016027:Heart Transplantation / Q000706:statistics & numerical data*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D007223:Infant; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D009864:Ontario / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D065095:Calcineurin Inhibitors