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Renal transplantation in infants, a therapeutic option?
1Department of Pediatrics, University of Minnesota School of Medicine, Variety Club Children's Hospital, Minneapolis.
Insights
Infants can successfully receive kidney transplants, achieving survival rates comparable to older children. This procedure supports catch-up growth and development, making it a vital therapy for pediatric end-stage renal failure.
Area of Science:
- Pediatric Nephrology
- Transplantation Surgery
- Pediatric Urology
Background:
- End-stage renal failure in childhood necessitates treatment, with renal transplantation being the preferred option.
- Dialysis is established for infants with renal failure, raising questions about the feasibility and outcomes of renal transplantation in this age group.
Purpose of the Study:
- To evaluate the efficacy and outcomes of renal transplantation in infants.
- To determine if infants can achieve comparable results to older children undergoing kidney transplants.
Main Methods:
- Review of existing literature on infant renal transplantation.
- Analysis of clinical experience with infant renal transplantation at the University of Minnesota.
Main Results:
- Renal transplantation is feasible and successful in infants.
- Patient and graft survival rates in infants are comparable to those in older children.
- Successful transplants in infants lead to catch-up growth and accelerated psychomotor development.
Conclusions:
- Renal transplantation should be considered a standard and integral therapy for infants with chronic renal failure.
- Outcomes for infant renal transplantation are favorable, with benefits including improved growth and development.
- Challenges in infant transplantation are generally similar to those in older pediatric recipients.
Abstract:
Renal transplantation is widely accepted as the treatment of choice for endstage renal failure in childhood. Since dialysis is regularly applied to infants with renal failure, the question logically arises, can infants also receive renal transplants and what are the outcomes? A review of the literature and the clinical experience at the University of Minnesota supports the performance of renal transplantation in infancy. Present patient and graft survival rates for infants are indistinguishable from those of older children. While living adult donors are preferred, adult cadaveric kidneys have also been successfully transplanted. Following successful transplantation, the infants have generally enjoyed "catch-up" growth and accelerated psychomotor development. While there may be problems related to fluid and electrolyte balance in these smallest patients, the majority of the problems encountered mirror those seen in any child undergoing transplantation. Renal transplantation is regularly successful in infancy and should be considered an integral component of the therapy for any child with chronic renal failure.