title: Renal Impairment and Complication After Kidney Transplant at Queen Rania Abdulla Children's Hospital.
abstract: OBJECTIVE
  Kidney transplant is the treatment of choice for end-stage renal disease, but it is not without complications. We review the medical cause of significant renal impairment and complications that developed after kidney transplant in pediatric patients who required hospital admission and intervention and/or who were followed between 2007 and 2016.
  
  
  METHODS
  A retrospective noninterventional chart review study was conducted in pediatric patients who received a kidney transplant and/or followed at the nephrology clinic at Queen Rania Abdulla Children's Hospital between 2007 and 2016.
  
  
  RESULTS
  In this study, 101 pediatric patients received a total of 103 transplants. Forty-eight patients (47%) experienced deterioration of kidney function out of a total of 53 episodes of complications; 37 of these episodes occurred early (0-6 mo after transplant), and 26 episodes occurred late. The causes of kidney function deterioration were surgical complications, acute tubular necrosis, cell- or antibody-mediated rejection, diabetes mellitus, urinary leak, recurrence of original disease, and chronic allograft nephropathy. Thirteen patients experienced graft loss; 50% of these losses were secondary to noncompliance to immunosuppressant medication treatment after transplant. A total of six patients died; 2 (23%) of these deaths occurred in the first week after transplant, whereas the other 4 patients died over a period of 10 years.
  
  
  CONCLUSIONS
  Pediatric kidney transplant is not without complications; however, most of these complications are treatable and reversible. The most serious complications leading to graft loss and death occur early, in the first week after transplant. Improving immunosuppressant compliance after transplant would prevent 50% of graft losses.
authors.affiliation: Queen Rania Abdulla Children's Hospital, Amman Jordan.
authors.forename: Reham Issa
authors.initials: RI
authors.lastname: Almardini
authors.forename: Ghazi Mohamad
authors.initials: GM
authors.lastname: Salita
authors.forename: Mahdi Qasem
authors.initials: MQ
authors.lastname: Farah
authors.forename: Issa Ahmad
authors.initials: IA
authors.lastname: Katatbeh
authors.forename: Katibh
authors.initials: K
authors.lastname: Al-Rabadi
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006776:Hospitals, Pediatric; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007597:Jordan; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D055118:Medication Adherence; D010359:Patient Readmission; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000503:physiopathology* / Q000517:prevention & control; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents