Evaluation of growth in low-body-weight kidney transplant Egyptian children: 25-year experience

Abstract

The current final height of low-body-weight transplant Egyptian children has remained suboptimal. The management of growth retardation posttransplant is multifactorial and should start early before transplantation, with optimal care of growth in children with chronic kidney disease. Moreover, expedited transplantation, whenever indicated, and optimization of posttransplant graft function with minimal steroid exposure are essential factors which were shown to be possible using immunosuppression based on tacrolimus plus mycophenolate mofetil, after basiliximab induction.

<p>The relation between zero-time pretransplant deceased donor renal biopsy and kidney transplant survival</p>

“…They received a living donor renal allotransplant and were retrospectively evaluated for survival, graft survival, as well as physical growth. Their results demonstrated that patient and graft survival rate at 1 year was 98.4% 28. Chamienia et al29 found delayed graft function in three cases and an acute rejection episode in four subjects among the 29 cases.…”

“…They reported that survival rate after deceased transplant was 89%, whereas that of living-donor transplants was 99% 27. Mossad et al28 designed a study with 63 renal transplant children, weighing 25 kg or less at the time of renal transplantation. They received a living donor renal allotransplant and were retrospectively evaluated for survival, graft survival, as well as physical growth.…”

“…Cox regression analysis showed that ESRD grade (HR =3.84, 95% CI =2.315–6.348; P <0.0001) and gender of deceased donors (HR =0.34, 95% CI =0.145–0.797; P =0.013) had independently been related to graft survival rate. Mossad et al28 demonstrated significant risk factors for growth retardation postrenal transplant, which included older age at time of transplant ( P =0.019), female gender ( P =0.010), retarded growth at time of transplant ( P =0.011), incidence of chronic rejection ( P =0.012), higher steroid cumulative dose ( P =0.013), and graft dysfunction ( P =0.009) 28. Rezaei et al30 showed that in the Cox model, four factors, including the presence of surgical or other complications, known primary disease, and donor–recipient relationship, had a significant association with patient survival, and seven factors, including the presence of surgical complications, known primary disease, donor–recipient relationship, gender, weight, same side transplanted kidney, and donor’s age, had significant relationship with graft survival 30.…”