Medical and surgical aspects of pediatric renal transplantation using living donors.
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.
Vester
U
U
Department of Pediatric Nephrology, University Hospital, Essen, Germany. udo.vester@medizin.uni-essen.de
Kranz
B
B
Testa
G
G
Paul
A
A
Broelsch
C E
CE
Hoyer
P F
PF
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