Pediatric renal transplantation; 10 years experience

Area of Science:

• Pediatric Nephrology
• Transplantation Surgery
• Urology

Background:

• Renal transplantation (RT) is the primary treatment for pediatric end-stage renal failure.
• Pediatric RT outcomes are significantly influenced by transplant center experience.
• Fewer children undergo RT compared to adults, highlighting a need for improved access and outcomes.

Purpose of the Study:

• To present the experience and outcomes of pediatric renal transplantation at a single center.
• To analyze the efficacy and challenges of pediatric RT over a ten-year period.
• To identify common etiologies, complications, and survival rates in pediatric kidney transplant recipients.

Main Methods:

• Retrospective analysis of 27 pediatric patients who underwent RT between April 2009 and April 2019.
• Data collected included patient demographics, etiology of end-stage renal disease (ESRD), donor type, pre-transplant dialysis, surgical complications, and graft survival.
• Evaluation of graft function, rejection episodes, and overall graft survival rates.

Main Results:

• The most common cause of ESRD was vesicourethral reflux; 66.7% of kidneys were from cadaveric donors.
• Bleeding was the most frequent surgical complication; delayed graft function occurred in 4 patients (all from cadaveric donors).
• Graft survival rates were 100% at 1 and 3 years, and 92% at 5 years, with graft loss in only 4 patients.

Conclusions:

• Establishing and maintaining a pediatric RT program requires significant effort and specialized care.
• Early detection and management of post-transplant complications are essential for optimizing outcomes.
• Further strategies are needed to enhance the success rates of pediatric renal transplantation.