The immediate postoperative complications and outcomes of kidney transplantation in children

Faizal, Mam; Dissanayake, M; Withanawasam, D; Dissanayake, D M A U K; Abeysekera, Chandra; Abeygunawardana, A.P.; Lamawansa, M.D.; Goonasekera, Chulananda

doi:10.4038/sljch.v41i2.4393

Cited by 1 publication

(4 citation statements)

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“…The survival rates for ICU patients and total patients were 78.9% and 97% among our pediatric RT recipients admitted to ICU. Our ICU survival rates were lower than other studies [8,9]. Although we included pediatric RT recipients admitted to the ICU in early and late periods after transplant, our overall survival rate was similar to other published studies [5,26].…”

Section: Discussionsupporting

confidence: 68%

“…Previous studies have reported incidences of immediate ICU admission in pediatric RT recipients of 77.7% to 100% [7][8][9]. Both our overall incidence (16.5%) and immediate incidence (3.5%) were lower than published studies among pediatric RT recipients admitted to the ICU [7,8].…”

Section: Discussioncontrasting

confidence: 66%

“…Our 24-hour mortality rate among all pediatric RT recipients was 0.9%, and the cause of mortality was not associated with RT. Faizal et al [8] reported that neither graft loss nor deaths occurred among pediatric RT recipients admitted to ICU in the immediate postoperative period. Pape et al showed that one patient (1%) died during ICU stay among their patient group [9].…”

Section: Discussionmentioning

confidence: 99%

“…The need for intensive care unit (ICU) follow-up may be seen in pediatric recipients with certain medical or perioperative complications after RT [5,6]. Although most pediatric RT recipients do not require ICU admission in the immediate posttransplant period, some centers may routinely admit them [7][8][9]. However, in the early and late post-operative phases, there are available clinical data about pediatric RT recipients who are admitted to ICU.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of pediatric renal transplant recipients admitted to the intensive care unit: A retrospective cohort study

Yeşiler¹,

Kaya²,

Şahintürk³

et al. 2023

J Surg Med

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Background/Aim: The best course of treatment for children with end-stage kidney disease (ESKD) is renal transplantation (RT), but some pediatric RT recipients are admitted to an intensive care unit (ICU) post-transplant. In the early and late post-operative phases, clinical data about pediatric RT recipients who are admitted to ICU are available. In this study, we aimed to evaluate demographic features, main reasons, and outcomes of pediatric RT patients admitted to the ICU during the early and late post-operative phases. Methods: This study was a cohort study. We analyzed the medical records of pediatric RT recipients (<18 years of age) who were admitted to the ICU between May 30, 2011, and October 16, 2021, at our center, retrospectively. Patients ≥18 years of age and those without available data were excluded. We obtained the following data from ICU follow-up records and hospital medical records. The median (minimum-maximum) for continuous variables, frequencies, and percentages for categorical variables were used. The Chi-square test was used to compare categorical variables. We created graphs using percentages and frequencies to summarize the results. Results: Nineteen (16.5%) of the 115 pediatric patients who underwent RT were admitted to the ICU during the study period. Thirteen patients (68.4%) were male, and the mean age was 10.2 (4.9) years. Hypertension (21.2%) was the most common comorbidity. Eighteen (94.7%) received transplants from living donors. Cystic-hereditary-congenital disorders (42.1%, n=8) and congenital anomalies of the kidney and urinary tract (26.3%, n=5) were among the etiologies of ESKD. Ten patients (52.6%) were admitted to the ICU >6 months after transplantation. Epileptic seizure (n=6, 31.6%), respiratory failure (n=4, 21.1%), and cardiac diseases (n=2, 10.5%) were among the main reasons for ICU admission. During ICU follow-up, invasive mechanical ventilation was needed for five patients (26.3%), and renal replacement treatment was needed for four patients (21.1%). The mean length of ICU was 12.4 (28.5), and the mean hospital stay was 25.8 (29.4) days. The ICU and hospital survival rates were 78.9% and 97%, respectively, while 3.5% was the hospital mortality rate. Hemorrhagic cerebrovascular disease, acute hepatic failure, and cardiogenic shock secondary to pericardiocentesis were the causes of death in the ICU. Conclusion: Patients mostly had ICU admissions because of epileptic seizures and acute respiratory failure. A multidisciplinary approach involving pediatric nephrologists, transplant surgeons, and an intensive care team successfully manages pediatric RT recipients admitted to the intensive care unit.

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Section: Discussionsupporting

confidence: 68%