Related Experiment Video
Updated: Dec 27, 2025
Murine Kidney Transplant Technique
Published on: October 20, 2015
Pediatric Kidney Transplantation in Perú: A Single-Center Initial Experience
Manuel Moreno Gonzales1, José Duran2, Omar Ponce2
1Department of Surgery, Clínica Anglo Americana, Lima, Peru; Organ Donation and Procurement Unit, Instituto Nacional de Salud del Niño San Borja, Lima, Peru.
Insights
Pediatric kidney transplantation (PKTx) offers the best therapy for children with end-stage renal disease (ESRD). This study shows good midterm results for PKTx in Peru, highlighting the need to improve access to this vital procedure.
Area of Science:
- Pediatric Nephrology
- Transplantation Surgery
- Immunology
Background:
- Pediatric kidney transplantation (PKTx) is the preferred treatment for end-stage renal disease (ESRD) in children globally.
- Access to PKTx in Peru is significantly limited by socioeconomic factors, healthcare infrastructure, and organ scarcity.
- A PKTx program was initiated at a leading pediatric institute in Peru, demonstrating promising midterm outcomes.
Purpose of the Study:
- To evaluate the outcomes of a newly established pediatric kidney transplantation program in Peru.
- To assess the feasibility and efficacy of PKTx in a resource-limited setting.
Main Methods:
- A retrospective analysis of prospectively collected data from December 2017 to August 2019.
- Fourteen pediatric kidney transplantations (PKTx) were performed.
- Protocols included pre-implantation/protocol biopsies, comprehensive antibody assessment (flow cytometry, PCR-based HLA typing), and triple immunosuppression (tacrolimus, mycophenolate mofetil, steroids) with induction therapy.
Main Results:
- The mean recipient age was 14.14 years; 57.14% were male.
- 50% of ESRD cases had undetermined etiology; 78.57% received deceased donor allografts.
- Complications included delayed graft function (7.14%), graft dysfunction with hematuria (7.14%), and one case of oligoastrocytoma (7.14%) post-transplant.
Conclusions:
- PKTx remains the optimal therapy for pediatric ESRD.
- This study demonstrates that successful PKTx with good midterm results is achievable even in resource-limited countries like Peru.
- Improving access to pediatric kidney transplantation is crucial, particularly for underserved populations.
Background:
Pediatric kidney transplantation (PKTx) is the preferred therapy for children with end-stage renal disease (ESRD) worldwide. Regrettably, in Perú, access to PKTx is extremely difficult due to recipient/donor socio-economic status, health care structure and especially, scarcity of organs. Our center (the only pediatric institute in the country) has recently started a PKTx program with good midterm results. The aim of this study was to present our outcomes.
Methods:
Retrospective analysis of prospectively collected data between December 2017 and August 2019. Fourteen PKTx (< 18 years old) were achieved. As per our protocol: pre-implantation/protocol biopsies, antibody assessment (T/B cell flow cytometric plus HLA testing applying polymerase chain reaction-based technology), triple immunosuppression (tacrolimus, mycophenolate mofetil, steroids) and induction therapy was performed in every case.
Results:
The recipient's mean age at the time of PKTx was 14.14 ± 2.62, 8/14 (57.14%) were male, 50% developed ESRD due to undetermined etiology, 11/14 (78.57%) received a deceased donor allograft, and 9/14 (64.28%) required induction with thymoglobulin. Postoperative complications included: delayed graft function (1/14, 7.14%), 1 (7.14%) developed gross hematuria associated with allograft disfunction post-protocol allograft biopsy that was managed conservatively and 1 recipient (7.14%) developed grade II oligoastrocytoma, at 10 months post PKTx.
Conclusions:
PKTx is the best therapeutic option for children with ESRD. Our group demonstrated that even in countries with limited resources like Perú, good midterm results can be achieved. Emphasis should be given to improve access to transplantation especially in the setting of pediatric recipients.
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