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Outcome of renal transplantation in children with pericardiopleural effusion
1Department of Urology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. yuiok2681@cgmh.org.tw
Insights
Renal transplantation is effective for children with end-stage renal disease and pericardiopleural effusion. Close cardiopulmonary monitoring is crucial post-transplant for these high-risk pediatric patients.
Area of Science:
- Pediatric Nephrology
- Cardiology
- Transplantation Surgery
Background:
- Children with end-stage renal disease (ESRD) often develop pericardiopleural effusion due to fluid overload.
- This effusion can complicate management and impact outcomes in pediatric ESRD patients.
Purpose of the Study:
- To evaluate the efficacy and safety of renal transplantation in pediatric patients with ESRD and pericardiopleural effusion.
- To assess the long-term outcomes and potential complications in this specific patient cohort.
Main Methods:
- Retrospective analysis of six pediatric patients (under 18) who underwent renal transplantation between 1981 and 2001.
- Patients presented with pericardiopleural effusion, congestive heart failure, ascites, or splenomegaly, and had undergone hemodialysis prior to transplant.
Main Results:
- Five of six patients survived with functioning grafts after a median follow-up of 11 years.
- One patient died due to heart failure post-transplantation.
- Graft function remained stable with acceptable serum creatinine levels post-transplant.
Conclusions:
- Renal transplantation demonstrates a high success rate in pediatric patients with ESRD and pericardiopleural effusion.
- Continuous cardiopulmonary monitoring is essential for managing potential post-transplant complications in these vulnerable children.
Introduction:
Children with end-stage renal disease may present with pericardiopleural effusion secondary to volume overload and overhydration. The present study was designed to investigate the efficacy and safety of renal transplantation in these pediatric patients.
Methods:
From 1981 to 2001, six of 20 patients (30%) under 18 years old who received renal transplants showed pericardiopleural effusion after serial pretransplant imaging studies. These patients also displayed associated diseases, such as congestive heart failure (n = 3), ascites (n = 2), and splenomegaly (n = 2). The recipients included five boys and one girl of mean age of 12.7 years (range, 8 to 17 years), all of whom had undergone hemodialysis before transplantation. The waiting time for grafts ranged from 1.3 to 6 years (mean = 2.6 years). Episodes of acute pulmonary edema had been observed in three patients pretransplant.
Results:
One recipient died with a functioning graft due to heart failure with acute pulmonary edema at 4 months after transplantation. Acute rejection episodes were observed in three, and chronic rejection in two children. The median follow-up was 11 years (range = 6 to 16 years) in the other five recipients, all of whom presently survive with functioning grafts. The posttransplant mean serum creatinine levels at 1 year, 3 years, and 5 years were 1.54 +/- 0.44, 1.74 +/- 0.56, and 1.92 +/- 0.56 mg/dL, respectively.
Conclusion:
Renal transplantation in children displaying pericardiopleural effusion was associated with a high success rate. However, these patients must be followed closely with regular cardiopulmonary evaluation since their condition may deteriorate.
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