title: Medical and surgical aspects of pediatric renal transplantation using living donors.
abstract: The outcomes of 19 consecutive living-donor renal transplants (LD-RTx) was compared with 41 cadaveric grafts (CD-RTx) performed at our institution using basiliximab, cyclosporine, and prednisone as standard immunosuppression. LD-RTx significantly shortened the waiting time on dialysis. However, patient survival (100% in both groups), 1-year graft survival (94.7% vs 90%), and rejection-free graft survival (76.9% vs 73.5%) was not significantly different. LD-RTx showed better glomerular filtration rates in the early phase after transplantation, a difference that faded with time. Graft function was similar after 1 and 2 years. LD grafts with double renal arteries were used successfully in four cases; heparin therapy was administered to avoid graft thrombosis. A significantly greater number of lymphoceles was observed with LD grafts (7/19 vs 1/41, P < .01). In conclusion with improved immunosuppression producing better results with CD grafts, the advantages of LD-RTx have vanished. LD grafts with double arteries may be used successfully and LD-RTx allows a shorter dialysis period. The high incidence of lymphoceles in our series awaits further evaluation.
authors.affiliation: Department of Pediatric Nephrology, University Hospital, Essen, Germany. udo.vester@medizin.uni-essen.de
authors.forename: U
authors.initials: U
authors.lastname: Vester
authors.forename: B
authors.initials: B
authors.lastname: Kranz
authors.forename: G
authors.initials: G
authors.lastname: Testa
authors.forename: A
authors.initials: A
authors.lastname: Paul
authors.forename: C E
authors.initials: CE
authors.lastname: Broelsch
authors.forename: P F
authors.initials: PF
authors.lastname: Hoyer
mesh_terms: D002648:Child; D005260:Female; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology*; D019520:Living Donors; D008297:Male; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome