title: Long-term outcome of pediatric renal transplantation: a single center experience.
abstract: Renal transplantation is the optimal treatment for pediatric end-stage renal disease. We examined 51 children <20 yr old who underwent a total of 52 living-donor renal transplantations at Osaka University Hospital between 1972 and 2004. The mean age at transplantation was 13.7 (3-19 yr). The mean duration of follow-up was 16.5 yr. The five-, 10-, and 20-yr patient survival rates following renal transplantation were 94%, 90%, and 87%, respectively. The five-, 10-, and 20-yr graft survival rates were 76%, 65%, and 48%, respectively. A double-drug regimen was used before 1987; this was replaced by a triple-drug regimen including a calcineurin inhibitor in 1988. The five-, 10-, and 20-yr graft survival rates after 1988 (89%, 80%, and 60%, respectively) were higher than those before 1987. Growth was examined among patients <15 yr old at the time of surgery, and height standard deviation (SD) scores (Z-scores) were analyzed in 14 patients who displayed favorable renal function after transplantation. At the time of transplantation, mean SD score (SDS) was -2.39, and mean final adult SDS was -1.79. Rates of patient and graft survival after renal transplantation were mostly favorable. Future goals must include overcoming chronic rejection and establishing a steroid discontinuation protocol to improve growth.
authors.affiliation: Department of Specific Organ Regulation, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Toyofumi
authors.initials: T
authors.lastname: Abe
authors.forename: Naotsugu
authors.initials: N
authors.lastname: Ichimaru
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kakuta
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Okumi
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Imamura
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Isaka
authors.forename: Shiro
authors.initials: S
authors.lastname: Takahara
authors.forename: Yukito
authors.initials: Y
authors.lastname: Kokado
authors.forename: Akihiko
authors.initials: A
authors.lastname: Okuyama
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000401:mortality* / Q000706:statistics & numerical data*; D008297:Male; D011183:Postoperative Complications; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult