Early risk factors in pediatric renal transplantation at a single center

Talbot, David; Achilleos, Orthodoxos; Mirza, Darius F.; Buckels, J. A. C.; Mayer, AD; Milford, David V.

doi:10.1016/s0022-3468(98)90016-1

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…Most authors suggest that the best option is a living donor , followed by an adult‐sized deceased donor . The last choice would be a pediatric donor, preferably >6 yr of age and, if possible, >10 yr of age . The main exception would be a potential recipient with a thrombosed IVC, who would require a small kidney with a graft vein implanted in the remaining pelvic vein and venous return across venous collaterals in the pelvic, lumbar, and paraspinous areas.…”

Section: Discussionmentioning

confidence: 99%

Kidney transplantation in children weighing less than 15 kg: Extraperitoneal surgical access–experience with 62 cases

Vitola

Gnatta

Garcı́a

et al. 2013

Pediatric Transplantation

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Small children are a challenging group in whom to perform KT. This retrospective study analyzed the results of 62 KTs in children weighing <15 kg, performed between 1998 and 2010, using extraperitoneal access and anastomosis of the renal vessels of donors to the aorta and IVC or iliac vessels of the recipients. Thirty-two (51.6%) grafts were LRDTs and 30 (48.4%) were DDRTs-28 of them pediatric. The mean age at KT was 3.7 ± 2.2 yr (1-12), and the mean weight was 12.3 ± 2.1 kg (5.6-14.9). Ten children weighed <10 kg, and five (8.1%) children presented previous thrombosis of the venous system. At one and five yr, patient survival was 93.2% and 84.2%, and graft survival was 85.2% and 72.7%. There were no differences between the rates for LRDT and DDRT. There were six vascular complications (four vascular thromboses, one laceration, and one renal artery stenosis) and two perirenal collections. Extraperitoneal access is a valid KT technique in children weighing <15 kg.

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Section: Discussionmentioning

confidence: 99%

Kidney transplantation in children weighing less than 15 kg: Extraperitoneal surgical access–experience with 62 cases

Vitola

Gnatta

Garcı́a

et al. 2013

Pediatric Transplantation

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“…In previous studies, it was shown that kidneys from paediatric donors had a decreased graft survival rate caused by infections and technical problems compared with organs from adult donors [21,22]. Graft loss was seen mainly in donor organs from paediatric donors <5 years of age [23].…”

Section: Discussionmentioning

confidence: 99%

Paediatric kidney transplantation in small children - a single centre experience

Becker¹,

Neipp²,

Reichart³

et al. 2006

Transplant Int

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Summary Kidney transplantation (KTx) remains a challenging procedure in small children. This study presents our centre results. From 1983 to 2004, 40 of 442 paediatric KTx were performed in children with a body weight <11 kg. Median body weight was 9.2 kg (range: 7.2–10.9), median age was 2.7 years (range: 0.9–5.9). Preoperative dialysis was performed in 87.5%. In 24 cases (60%) grafts came from cadaveric (CAD) and in 16 cases (40%) from living related donors (LRD). Median donor age of CAD was 8 years (range: 1–40). The overall 1‐, 5‐, 10‐, 15‐year patient survival was 93%, 90%, 90% and 87% respectively. The overall 1‐, 5‐, 10‐, 15‐year graft survival was 90%, 80%, 66% and 56% respectively. There was no significant difference in survival of CAD or LRD grafts. Median follow‐up was 13.7 years. Initial graft function rate was 100% for LRD and 79% for CAD. The relative glomerular filtration rate (GFR) showed no statistical difference between CAD and LRD. Main reasons for graft loss were chronic transplant nephropathy. Paediatric KTx is the treatment of choice even in very small children. Living donor KTx is the preferable donor source in terms of primary graft function and timing to transplantation.

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“…Traditionally, kidneys from young pediatric donors (<5 years of age) have not been used in infant RTx, as the early reports showed a decreased graft survival rate caused by infections and technical problems [25][26][27][28]. However, more recent data indicate that a pediatric donor organ can adapt the glomerular filtration rate (GFR) with the recipient's growth and these grafts would provide even better long-term results [29,30].…”

Section: Donor Characteristicsmentioning

confidence: 99%

Renal transplantation in infants

2015

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Renal transplantation (RTx) has become an accepted mode of therapy in infants with severe renal failure. The major indications are structural abnormalities of the urinary tract, congenital nephrotic syndrome, polycystic diseases, and neonatal kidney injury. Assessment of these infants needs expertise and time as well as active treatment before RTx to ensure optimal growth and development, and to avoid complications that could lead to permanent neurological defects. RTx can be performed already in infants weighing around 5 kg, but most operations occur in infants with a weight of 10 kg or more. Perioperative management focuses on adequate perfusion of the allograft and avoidance of thrombotic and other surgical complications. Important long-term issues include rejections, infections, graft function, growth, bone health, metabolic problems, neurocognitive development, adherence to medication, pubertal maturation, and quality of life. The overall outcome of infant RTx has dramatically improved, with long-term patient and graft survivals of over 90 and 80 %, respectively.

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Early risk factors in pediatric renal transplantation at a single center

Cited by 5 publications

References 8 publications

Kidney transplantation in children weighing less than 15 kg: Extraperitoneal surgical access–experience with 62 cases

Kidney transplantation in children weighing less than 15 kg: Extraperitoneal surgical access–experience with 62 cases

Paediatric kidney transplantation in small children - a single centre experience

Renal transplantation in infants

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