Outcome of living kidney transplant: pediatric in comparison to adults.
BACKGROUND
Renal transplantation is the most optimal way to manage children with end-stage renal disease. Despite its benefits, pediatric renal transplantation is a challenge for several transplantation centers in terms of achieving a satisfactory outcome. We sought to compare the long-term outcome of pediatric versus adult recipients who underwent renal transplantation.


METHODS
We examined, 2631 recipients of a first kidney from a living donor between 1982 and 2002. The two groups were matched for immunosuppressive therapy and number of HLA mismatches. The patients were divided into a pediatric (n=301; age <or= 18 years) and an adult group (n=2330; age > 18 years) to compare 5-year patient and graft survivals.


RESULTS
The mean ages of the pediatric and adult groups were 40 +/- 13 and 14 +/- 13 years, respectively. The 5-year graft survival was lower among the pediatric versus the adult group (56% vs 68%; P=.015) with no difference in patient survival (88% vs 86%; P>.05).


CONCLUSIONS
The poorer graft survival in pediatric transplantation may be due to the nature of pediatric transplantation, in terms of inconsistent adherence to medication regimens, worse side effects of medications, higher rate of graft rejection due to recurrent disease, and more intense immunoreactivity of children.
Torkaman
M
M
Nephrology/Urology Research Center (NURC), Baqiyatallah Medical Sciences University, Tehran, Iran. torkaman.mohammad@gmail.com
Khalili-Matin-Zadeh
Z
Z
Azizabadi-Farahani
M
M
Moghani-Lankarani
M
M
Assari
S
S
Pourfarziani
V
V
Saadat
S H
SH
Kavehmanesh
Z
Z
Afshar-Payman
S
S
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology*; D019520:Living Donors; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome