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Renal transplantation in the infant and young child
A Kalia1, B H Brouhard, L B Travis
1Department of Pediatrics, University of Texas Medical Branch, Galveston, TX 77550.
Insights
Pediatric renal transplantation in young children and infants shows promising long-term graft survival and improved growth. Successful kidney transplants benefit young recipients, enabling normal development and academic achievement.
Area of Science:
- Pediatric Nephrology
- Transplantation Surgery
- Pediatric Urology
Background:
- Renal transplantation is a critical treatment for end-stage renal disease in children.
- Limited data exists on the outcomes of renal transplantation in very young children (≤5 years).
Purpose of the Study:
- To evaluate the efficacy and long-term outcomes of renal transplantation in children aged 5 years or younger.
- To assess graft survival, patient survival, and developmental outcomes post-transplantation.
Main Methods:
- Retrospective analysis of 14 renal transplantations in 13 children aged 5 years or younger.
- Follow-up duration averaged 68 months (range: 14-203 months).
- Assessment of graft function, patient survival, growth, and academic performance.
Main Results:
- Eleven of 13 children are alive with successful graft function in nine.
- Graft survival rates were 92% at 1 year, and 73% at 2 and 5 years.
- All growth-retarded children demonstrated sustained catch-up growth; school-aged children performed at grade level.
Conclusions:
- Infants and young children are suitable candidates for renal transplantation.
- Successful renal transplantation leads to significant improvements in growth and development.
- Long-term graft survival is achievable in this pediatric population.
Abstract:
Fourteen renal transplantations were performed in 13 children, aged 5 years or younger, including three infants. The mean duration of follow-up was 68 months, with a range of 14 to 203 months. Eleven children are alive; of these, nine had prolonged graft function. Graft survival rate was 92% at one year and 73% at two and five years following surgery. Sustained catch-up growth occurred in all growth-retarded children who underwent successful transplantation. At this writing, the oldest patient is 20 years of age and a junior in college; all school-age children are functioning at the appropriate grade level, except one, who is one year behind. The youngest child is 3 years old and is developing normally. Infants and young children appear to be good candidates for renal transplantation.