[Pediatric kidney transplantation].

Area of Science:

• Pediatric Nephrology
• Transplantation Immunology
• Clinical Pediatrics

Background:

• Pediatric end-stage renal disease (ESRD) significantly impacts growth and quality of life.
• Optimizing immunosuppression and surgical strategies are crucial for successful pediatric kidney transplantation.
• Viral infections and graft survival remain significant challenges in pediatric recipients.

Purpose of the Study:

• To evaluate outcomes of pediatric renal transplantation using a basiliximab induction and steroid withdrawal regimen.
• To assess the impact of this regimen on patient/graft survival, growth, and infection rates.
• To provide recommendations for preemptive and living donor kidney transplantation in children.

Main Methods:

• Retrospective analysis of 30 pediatric renal transplant recipients.
• Basiliximab induction with ciclosporin and mycophenolate mofetil, including steroid withdrawal in some patients.
• Monitoring for viral infections (CMV, EBV) and cardiovascular parameters.

Main Results:

• Achieved high patient/graft survival rates (1 and 2 years: 100%/96.6%).
• Significantly improved height standard deviation scores post-transplantation.
• Viral infections (CMV, EBV) managed with preemptive treatment and specific antivirals; pneumococcal infection was rare.
• Living donor transplantation preferred for small children; ABO incompatible transplantation showed good outcomes.
• Cardiovascular monitoring essential for size mismatch.

Conclusions:

• Basiliximab induction with steroid withdrawal is effective in pediatric renal transplantation, improving growth.
• Preemptive and living donor kidney transplantation are recommended for children with ESRD.
• Careful management of viral infections and cardiovascular status is vital for optimal outcomes.