Pediatric renal transplantation: a single-center experience in northeast Thailand.
OBJECTIVE
To clarify the demographic data, outcomes and complications of renal transplantation in children at Srinagarind (university) Hospital.


METHODS
The authors reviewed the medical records of children with end-stage renal disease (ESRD) who received renal transplantation at Srinagarind Hospital, Khon Kaen, between August 2001 and July 2008.


RESULTS
Eight male and seven female patients were identified Their mean age was 12.8 +/- 3.2 years (range, 5.0-17.6). The major cause of ESRD was a congenital anomaly of the kidneys (53%). All of the children received cadaveric transplantations and none received induction therapy. Triple immunosuppressive drugs comprising cyclosporine, prednisolone and mycophenolate mofetil were administered to 12 patients. Tacrolimus, instead of cyclosporine, was given to three patients who had received a renal transplant since January 2008. The median follow-up time was 15 months (3 to 82 months). The most frequent complication was urinary tract infection (40%). Acute graft loss was found in one patient (6.7%) due to graft infarction. Other complications included herpes viral infection, chronic rejection, acute rejection, severe gingival hyperplasia, myopathy, lymphocele and transitional cell carcinoma of the bladder. Two patients returned to dialysis due to graft infarction and chronic rejection, respectively. The mean serum creatinine at the last follow-up of the remaining cases was 1.2 +/- 0.5 mg/dL (range, 0.6-2.3). All of the patients survived. The 1- and 5-year graft survival rates were 93.3% and 86.7%, respectively.


CONCLUSIONS
The present study demonstrates the potential for successful outcomes of pediatric renal transplantation in this resource-limited area.
Wisanuyotin
Suwannee
S
Pediatric Department, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. drsuwannee@yahoo.com
Jiravuttipong
Apichat
A
D000293:Adolescent; D000367:Age Factors; D002102:Cadaver; D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D007668:Kidney / Q000002:abnormalities; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use; D013785:Thailand
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D009173:Mycophenolic Acid; D016559:Tacrolimus