Renal Transplantation in Children

Sozen, Hakan; Dalgic, A.; Karakayalı, H.; Baskın, Esra; Saatçi, U; Arslan, G.; Haberal, Mehmet

doi:10.1016/j.transproceed.2006.01.014

Cited by 26 publications

(18 citation statements)

References 9 publications

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“…1 Briefly, we use a retroperitoneal approach for recipients with body weights greater than 25 kg. An intra-abdominal placement of graft is preferred for infants who are less than 20 kg.…”

Section: Methodsmentioning

confidence: 99%

“…The obstacles shown in pediatric patients with renal failure include hospitalizations, psychosocial effects of dialysis, immature immune system, and elusive donor matching according to body size. 1,2 Renal transplant procedures in pediatric patients are performed later than in adult patients, with desired success achieved soon after because of difficulties previously mentioned. 1,2 Despite the advances in surgical techniques and immunosuppressive regimens, surgical complications remain important clinical problems, which may increase the morbidity rates, duration of hospital stay, and costs.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Renal transplant procedures in pediatric patients are performed later than in adult patients, with desired success achieved soon after because of difficulties previously mentioned. 1,2 Despite the advances in surgical techniques and immunosuppressive regimens, surgical complications remain important clinical problems, which may increase the morbidity rates, duration of hospital stay, and costs. Some of these complications can be life threatening, and early recognition of these complications and treatment can save both the patient and the graft.…”

Section: Introductionmentioning

confidence: 99%

“…Pediatric patients can catch up with normal growth and development through an optimum and controlled immunosuppressive treatment plan after transplant. [1][2][3] …”

Section: Introductionmentioning

confidence: 99%

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Surgical Complications After Pediatric Renal Transplant

Sozen

Fidan²,

Onur³

et al. 2019

Exp Clin Transplant

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Objectives: Renal transplant is the most appropriate treatment for both adult and pediatric patients with end-stage renal failure. Here, we analyzed surgical complications after pediatric renal transplant at our center. Materials and Methods:We retrospectively analyzed data from patient files and hospital charts of pediatric patients who had renal transplant at our center (Gazi University, Ankara, Turkey). Our immunosuppression protocol, a calcineurin inhibitor-based triple regimen, was applied to all recipients (steroids, mycophenolic acid). For neo-ureterocystostomy anastomosis, we used the corner-saving, open-loop continuous suture technique with double J stent for all patients, except when faced with an unfavorable situation. Catheters were removed within 4 weeks after transplant. Results: Among 40 pediatric renal transplant procedures performed at our center since 2006, we had 6 documented surgical complications (15%), with 3 being early and 3 being late complications. In the early transplant period, there were 2 surgical and 1 urologic complications. Eight patients (20%) lost their kidney grafts over the 10-year follow-up. The main reasons for graft loss were chronic allograft nephropathy in 4 patients (10%), BK virus nephropathy in 3 patients (7.5%), and hyperacute rejection in 1 patient (2.5%). Two patients died; however, no patient deaths or graft losses were from surgical complications. Overall graft and patient survival rates were 97% and 100% at 1 year, 94% and 98% at 5 years, and 68% and 95% at 10 years. Conclusions: Renal transplant in pediatric patients is a safe procedure in our department, based on patient and graft survivals, with a low rate of graft loss from surgical problems. As a result, our center is showing success with pediatric renal transplant procedures in accordance with the developed centers in the world.

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“…1 Briefly, we use a retroperitoneal approach for recipients with body weights greater than 25 kg. An intra-abdominal placement of graft is preferred for infants who are less than 20 kg.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Pediatric patients can catch up with normal growth and development through an optimum and controlled immunosuppressive treatment plan after transplant. [1][2][3] …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical Complications After Pediatric Renal Transplant

Sozen

Fidan²,

Onur³

et al. 2019

Exp Clin Transplant

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show abstract

“…These wide variations depend on economics, nephrologists, availability of dialysis services and sociocultural factors (6,7,(17)(18)(19). RRT data on children in pmcp are only available from Brazil 6.5, Turkey 11.9, Kuwait 17 and Malaysia 8 pmcp, respectively (10,15,20,21).…”

Section: Access To Renal Replacement Therapymentioning

confidence: 99%

Pediatric Kidney Transplantation in the Developing World: Challenges and Solutions

Rizvi

Sultan

Zafar

et al. 2013

American Journal of Transplantation

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The prevalence of pediatric RRT and transplantation are low in developing countries, 6-12 and <1 to 5 per million child population (pmcp), respectively. This is due to low GDP/capita of <$10 000, government expenditure on health of <2.6-9% of GDP and paucity of facilities. The reported incidence of pediatric CKD and ESRD is <1.0-8 and 3.4-35 pmcp, respectively. RRT and transplantation are offered mostly in private centers in cities where HD costs $20-100/session and transplants $10 000-20 000. High costs and long distance to centers results in treatment refusal in up to 35% of the cases. In this backdrop 75-85% of children with ESRD are disfranchised from RRT and transplantation. Our center initiated an integrated dialysis-transplant program funded by a community-government partnership where RRT and transplantation was provided ''free of cost'' with life long follow-up and medication. Access to free RRT at doorsteps and transplantation lead to societal acceptance of transplantation as the therapy of choice for ESRD. This enabled us to perform 475 pediatric transplants in 25 years with 1-and 5-year graft survival of 96% and 81%, respectively. Our model shows that pediatric transplantation is possible in developing countries when freely available and accessible to all who need it in the public sector.

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Secondary Forms of Hypertension in Children and Adolescents

Vidi

Meyers

2013

Pediatric Hypertension

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Renal Transplantation in Children

Cited by 26 publications

References 9 publications

Surgical Complications After Pediatric Renal Transplant

Surgical Complications After Pediatric Renal Transplant

Pediatric Kidney Transplantation in the Developing World: Challenges and Solutions

Secondary Forms of Hypertension in Children and Adolescents

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