Paediatric renal transplantation--a 15 year experience.

Area of Science:

• Nephrology
• Pediatric Surgery
• Immunology

Background:

• End-stage renal disease (ESRD) in children presents significant challenges in developing countries.
• Renal transplantation is a potential life-saving treatment option for pediatric ESRD.
• Long-term outcomes of pediatric renal transplantation in resource-limited settings require evaluation.

Purpose of the Study:

• To assess the outcomes of pediatric renal transplantation over a 15-year period in a developing country.
• To identify factors influencing patient and graft survival.
• To evaluate the role of vesicoureteric reflux in pediatric ESRD and transplantation.

Main Methods:

• Retrospective analysis of 63 children (<15 years) undergoing living-related renal transplantation (1984-1996).
• Data collection on donor source, cause of ESRD, immunosuppression protocols, complications, and survival rates.
• Analysis of patient and graft survival at 1 and 3 years post-transplantation.

Main Results:

• Parents were donors in 84.3% of cases; reflux nephropathy was the most common cause of ESRD.
• Patient survival was 92% at 1 year and 90% at 3 years; graft survival was 88% at 1 year and 86% at 3 years.
• Complications occurred in 16 patients; 8 patients died and 2 returned to hemodialysis during follow-up.

Conclusions:

• Renal transplantation is an effective therapy for pediatric ESRD, providing medical, social, and functional rehabilitation.
• Vesicoureteric reflux may be underdiagnosed and requires active pursuit to prevent complications.
• The study highlights the feasibility and success of pediatric renal transplantation in a developing country context.