300 pediatric renal transplantations: A single-center experience.
Our objective was to relate the results of 300 consecutive kidney transplants performed in children at a single center.


METHODS
An analysis of kidney transplants was performed on patients less than 18 years old engrafted from May 1977 to August 2005.


RESULTS
Among 300 kidney transplants, 48% of the patients were female, 87% were Caucasian, and 13% were African-Brazilian. The mean age at transplant was 11.5 +/- 4.5 years with 39 (13%) less than 6 years of age. The most frequent etiology of renal failure was vesicoureteral reflux/obstructive uropathy (36%) followed by glomerulopathy (27%). The donor was deceased in 32.3% and living related in 77.7% (parents 82%). The mean posttransplant follow-up was 4.8 +/- 4.3 years. The initial immunosuppression was CyA + AZA + PRED in 45%; CyA + MMF + PRED in 9.6%; TAC + AZA + PRED in 7.3%; TAC + MF + PRED in 9.7%; or TAC + MF without PRED in 10%. Sirolimus was employed initially in three cases. Induction with OKT3/ATG occurred in three patients and 112 received an anti-IL2 receptor antibody. The 103 graft losses during 28 years of follow-up were secondary to chronic allograft nephropathy in 51 (49.5%), vascular thrombosis in 5 (4.8%), acute rejection in 12 (11.6%), and recurrence of original disease in 13 (12.6%). Sixteen (15.5%) died with functioning grafts. Graft survival in the first, fifth, and tenth year were 90%, 72%, and 59%, respectively. Patient survival in the first, fifth, and tenth years were 95%, 93%, and 85%, respectively, with infection as the main cause of death.
Garcia
C D
CD
Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Department of Nephrology, Porto Alegre, Brazil. cdgarcia1@uol.com.br
Bittencourt
V B
VB
Tumelero
A
A
Antonello
J S
JS
Moura
D M
DM
Vitola
S P
SP
Didone
E
E
Guerra
E
E
Pires
F
F
Garcia
V D
VD
D000293:Adolescent; D002102:Cadaver; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000601:surgery; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology*; D019520:Living Donors; D008297:Male; D051437:Renal Insufficiency / Q000209:etiology; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D014019:Tissue Donors