Pediatric live-donor kidney transplantation in Mansoura Urology & Nephrology Center: a 28-year perspective.
Our objective was to evaluate our overall experience in pediatric renal transplantation. Between March 1976 and March 2004, 1,600 live-donor kidney transplantations were carried out in our center; 216 of the patients were 18 years old or younger (mean age 12.9 years). There were 136 male patients and 80 female patients. The commonest causes of end-stage renal disease (ESRD) were renal dysplasia (22%), nephrotic syndrome (20%), hereditary nephritis (16%), and obstructive uropathy (16%). Of the donors, 94% were one-haplotype matched and the rest were identical. Pre-emptive transplantation was performed in 51 (23%) patients. Triple-therapy immunosuppression (prednisone + cyclosporine + azathioprine) was used in 78.2% of transplants. Rejection-free recipients constituted 47.7%. Hypertension (62%) was the commonest complication. A substantial proportion of patients (48%) were short, with height standard deviation score (SDS) less than -1.88. The overall infection rate was high, and the majority (53%) of infections were bacterial. The graft survival at 1 year, 5 years and 10 years were 93.4%, 73.3% and 48.2%, respectively, while the patients' survival at 1, 5 and 10 years were 97.6%, 87.8% and 75.3%, respectively. Despite long-term success results of pediatric renal transplantation in a developing country, there is a risk of significant morbidity.
El-Husseini
Amr A
AA
Mansoura Urology & Nephrology Center, Mansoura University, Mansoura, Egypt. amr_2000_2002@yahoo.com
Foda
Mohamed A
MA
Bakr
Mohamed A
MA
Shokeir
Ahmed A
AA
Sobh
Mohamed A
MA
Ghoneim
Mohamed A
MA
D000293:Adolescent; D001424:Bacterial Infections / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D004534:Egypt; D005190:Family; D005260:Female; D006085:Graft Survival / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000601:surgery*; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology* / Q000706:statistics & numerical data; D019520:Living Donors / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D009927:Tissue and Organ Procurement / Q000379:methods; D016896:Treatment Outcome