title: Urological complications, vesicoureteral reflux, and long-term graft survival rate after pediatric kidney transplantation.
abstract: To describe a single-center experience with kidney transplantation and then study some donor and recipient features that may impact on graft survival and urological complication rates. We reviewed our database searching for pediatric patients who underwent kidney transplantation from August 1985 through November 2012. Preoperative data and postoperative complications were recorded. Graft survival rates were analyzed and compared based on the type of donor, donor's age from deceased donors, and recipients' ESRD cause. Kaplan-Meier curves with log rank and Wilcoxon tests were used to perform the comparisons. There were 305 pediatric kidney transplants. The mean recipient's age was 11.7 yr. The mean follow-up was 11.0 yr. Arterial and venous thrombosis rates were 1.6% and 2.3%, respectively, while urinary fistula and symptomatic vesicoureteral reflux were diagnosed in 2.9% and 3.6% of cases, respectively. Deceased kidney transplantation had a lower graft survival rate than living kidney transplantation (log rank, p = 0.005). Donor's age (p = 0.420) and ESRD cause (p = 0.679) were not significantly related to graft survival rate. In long-term follow-up, type of donor, but not donor's age, impacts on graft survival rate. ESRD cause has no impact on graft survival rate, showing that well-evaluated recipients may have good outcomes.
authors.affiliation: Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Fabio C M
authors.initials: FC
authors.lastname: Torricelli
authors.affiliation: Department of Pediatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Andreia
authors.initials: A
authors.lastname: Watanabe
authors.affiliation: Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Affonso C
authors.initials: AC
authors.lastname: Piovesan
authors.affiliation: Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Ioannis M
authors.initials: IM
authors.lastname: Antonopoulos
authors.affiliation: Department of Nephrology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Elias
authors.initials: E
authors.lastname: David-Neto
authors.affiliation: Division of Urology, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: William C
authors.initials: WC
authors.lastname: Nahas
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology*; D016896:Treatment Outcome; D014548:Urinary Fistula / Q000453:epidemiology / Q000209:etiology*; D014718:Vesico-Ureteral Reflux / Q000453:epidemiology / Q000209:etiology*
keywords: kidney; pediatrics; survival; transplantation