Renal transplantation: experience in Australia.

Area of Science:

• Pediatric Nephrology
• Transplantation Immunology
• Pediatric Urology

Background:

• End-stage renal failure (ESRF) in children necessitates renal replacement therapy.
• Renal transplantation is a viable option for pediatric ESRF, aiming to improve survival and quality of life.
• Understanding long-term outcomes is crucial for optimizing pediatric kidney transplant protocols.

Purpose of the Study:

• To evaluate the outcomes of renal transplantation in children under 15 years old.
• To assess graft and patient survival rates following pediatric renal allografts.
• To identify major causes of graft loss in pediatric kidney transplant recipients.

Main Methods:

• Retrospective review of patient records and hospital renal registry data.
• Analysis of 64 renal transplants performed in 57 children between 1983 and 1997.
• Comparison of immunosuppressive regimens including Azathioprine, Prednisone, and Cyclosporine A.

Main Results:

• 10-year graft survival was 64%, with patient survival at 87%.
• Chronic rejection was the leading cause of graft loss (68%), followed by recurrence of primary disease.
• Transplanted children demonstrated good functional recovery, with most school-aged children attending school full-time.

Conclusions:

• Renal transplantation is a successful treatment for pediatric end-stage renal failure, offering high survival and improved life functioning.
• Chronic rejection remains a significant barrier to long-term graft success in pediatric kidney transplantation.
• Continued research into managing chronic rejection is vital for enhancing outcomes in pediatric renal allograft recipients.