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Gastrointestinal complications of renal transplantation in children
Insights
Serious gastrointestinal complications occurred in 16% of pediatric renal transplant patients. Most cases were successfully managed with prompt therapy, showing a lower mortality rate than in adults.
Area of Science:
- Pediatric Nephrology
- Gastroenterology
- Transplantation Medicine
Background:
- Renal homograft transplantation is a critical treatment for pediatric end-stage renal disease.
- Gastrointestinal complications are a known risk following transplantation, but data in pediatric populations are limited.
Purpose of the Study:
- To investigate the incidence, types, and outcomes of serious gastrointestinal complications in pediatric patients undergoing renal homograft transplantation.
- To compare the mortality rate of these complications in children versus adults.
Main Methods:
- Retrospective analysis of 85 consecutive pediatric patients (<17 years) who received renal homograft transplants.
- Documentation of all serious gastrointestinal complications, their specific diagnoses, and patient outcomes.
- Review of radiographic findings and their role in diagnosis and treatment.
Main Results:
- Twenty episodes of serious gastrointestinal complications were observed in 14 patients (16%).
- Complications included small-bowel obstruction, ulceration, pancreatitis, hepatitis, ascites, and severe gastroenteritis.
- A single death (1/14 patients) resulted from complications, significantly lower than adult transplantation rates.
Conclusions:
- Pediatric renal transplant recipients experience a notable incidence of serious gastrointestinal complications.
- These complications, while diverse, have a lower mortality rate in children compared to adults.
- Radiographic imaging is crucial for timely diagnosis and effective management of these complications.
Abstract:
Twenty episodes of serious gastrointestinal complication occurred in 14 of 85 (16%) consecutive patients less than 17 years old who underwent renal homograft transplantation. These complications consisted of small-bowel obstruction, ulceration, pancreatitis, hepatitis, ascites, and severe gastroenteritis. Only 1 patient died as a consequence of the complication--a much lower mortality rate than that reported for gastrointestinal complications of renal transplantation in adults. Radiographic findings were diagnostic in the majority of cases and aided in the prompt administration of therapy.