Pediatric renal transplantation: A single center experience over 14 years

• DOI: 10.1111/j.1399-3046.2005.00423.x
• Publication Date: 2005-10-21T15:28:27Z
• Authors: A. Delucchi; M. Ferrario; M. Varela; F. Cano; E. Rodriguez; J. L. Guerrero; A. M. Lillo; E. Wolff; J. Godoy; E. Buckel; G. Gonzalez; J. Rodriguez; G. Cavada
• Keywords: Single Center; Center (category theory)

Between 1989 and 2003, 100 transplants were performed in 96 patients at the pediatric nephrology unit of Calvo Mackenna Children's Hospital. Mean age 10.9 +/- 3.9 yr (1-17.6), 30% from LD. Donors younger than 5 five all recipients received an 'en bloc' graft. Original disease was hypo/dysplasia 27%, reflux nephropathy 22 17% chronic glomerulonephritis. The immunosuppressive protocol during first period (n = 56, 1989-2000): Cyclosporine, steroids azathioprine, second 44, 2001-2003): FK, steroids, MMF anti-CD25 antibody (mAbs). AR reported patients, 11% LD, 31% DD (p < 0.01). rate decreased 40 to 8% after monoclonal induction. Patient actuarial survival 1, 3 100% for LD 96% DD. overall graft 1,3, 96.7, 96.7 71% 89, 76 73% donors. Graft improved (1989-2000) (2001-2003; p 0.05). No difference with HLA-A,B,DR matching found. better when cold ischemia time <24 h CMV infections increased 19 40% Ab introduced height/age Z score post-transplant -2.2, -2.1, respectively, children older 7 -1.8, -1.9, -2.1 those transplanted who switched alternate day cause lost was: rejection eight, non-adherence four, four vascular thrombosis two. death two fungus septicemia accelerated rejection. Pediatric renal transplantation can be our group acceptable morbidity, low mortality rates similar other reports North America Western Europe. newer immunosuppression greater experience center. Management remain major challenges.