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Renal transplantation in children ages 1 to 5 years
Insights
Renal transplantation in very young children (ages 1-5) shows promising survival rates, comparable to older children. While some experienced growth acceleration, long-term height achievement remained a challenge, indicating transplantation is warranted for pediatric renal failure.
Area of Science:
- Pediatric Nephrology
- Transplant Surgery
- Immunology
Background:
- Renal failure in very young children presents unique challenges.
- Limited data exists on the outcomes of renal transplantation in this age group.
- Living-related donor (LRD) transplantation is a common approach.
Purpose of the Study:
- To evaluate the outcomes of renal transplantation in children aged 1 to 5 years.
- To assess patient survival, graft survival, and growth following transplantation.
- To compare outcomes in very young children with those in older pediatric age groups.
Main Methods:
- Retrospective analysis of 21 children (ages 1-5) undergoing renal transplantation.
- Eighteen patients received grafts from living-related donors (LRD).
- Patient and graft survival rates were calculated, and growth parameters were monitored post-transplant.
Main Results:
- Cumulative patient survival at 2 and 4 years post-LRD transplantation was 94% and 76%, respectively.
- Survival rates were comparable to those in children aged 6 to 14 years.
- Accelerated growth was observed in the first year for severely growth-retarded children with good graft function, though only one reached the 10th percentile for height.
Conclusions:
- Renal transplantation is a viable and warranted treatment option for very young children with end-stage renal disease.
- While survival rates are encouraging, long-term growth normalization remains a significant challenge.
- Further research is needed to optimize growth outcomes in pediatric renal transplant recipients.
Abstract:
Renal transplantation was carried out in 21 children ages 1 to 5 years. Eighteen received grafts from a living, related donor (LRD). Four children died, one following rejection, and three because of infection. Five children lost their initial grafts and two have received new transplants. Cumulative patient survival two and four years following LRD transplantation was 94% and 76%, respectively. This was similar to results found in children ages 6 to 14 years. Accelerated growth rates were seen in the first posttransplant year in those small children who were severely growth-retarded at the same time of transplantation and who achieved normal graft function. However, only one of these children ultimately reached the tenth percentile for height for chronological age. We conclude that renal transplantation is warranted in the very young child with renal failure.