Pediatric Kidney Transplantation in Perú: A Single-Center Initial Experience

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.