title: Pediatric kidney transplant with laparoscopic donor nephrectomy.
abstract: OBJECTIVE
  To evaluate outcomes and complications with pediatric living-donor kidney transplant, mostly performed with laparoscopic donor nephrectomy.
  
  
  METHODS
  In the 25 years between February 1987 and December 2012, there were 493 children aged ≤ 17 years who received a kidney transplant. Demographic characteristics, graft and patient survival, rejection episodes, and complications were recorded. Analysis was performed for 3 sequential periods (1987-1994, 1995-2002, and 2003-2012).
  
  
  RESULTS
  The mean patient age was 13 ± 4 years (age range, 2.5-17 y). There were 290 males (59%). Glomerulonephritis was the most common cause of end-stage renal disease. Preemptive kidney transplant was performed in 412 patients (84%). Donor nephrectomy was performed laparoscopically in 445 patients (90%). The 5-year graft and patient survival were improved from 1987-1994 to 2003-2012. The overall death-censored graft survival was 96% at 1 year, 78% at 5 years, and 66% at 10 years after transplant. The overall patient survival was 96% at 1 year, 83% at 5 years, and 75% at 10 years after transplant.
  
  
  CONCLUSIONS
  Kidney transplant is available for most pediatric patients and has acceptable graft and patient survivals. Laparoscopic donor nephrectomy improves donor satisfaction and morbidity, and may provide excellent graft outcomes in children.
authors.affiliation: From the Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Shahid Labbafinejad Medical Center, Tehran, Iran.
authors.forename: Nasser
authors.initials: N
authors.lastname: Simforoosh
authors.forename: Samad
authors.initials: S
authors.lastname: Zare
authors.forename: Abbas
authors.initials: A
authors.lastname: Basiri
authors.forename: Ali
authors.initials: A
authors.lastname: Tabibi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Samzadeh
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Soltani
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000209:etiology / Q000517:prevention & control; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D010535:Laparoscopy / Q000009:adverse effects / Q000401:mortality; D019520:Living Donors; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents