Pediatric renal transplantation: a single center experience

Area of Science:

• Pediatric Nephrology
• Transplantation Surgery
• Immunosuppression Therapy

Background:

• Global rise in end-stage renal disease (ESRD) poses significant health challenges, particularly for pediatric populations.
• Children with ESRD face elevated mortality risks despite available renal replacement therapies.
• Kidney transplantation offers superior survival rates compared to other treatments but presents challenges in pediatric cases due to recipient size and donor-recipient matching.

Purpose of the Study:

• To evaluate the outcomes of living donor kidney transplantation in children with ESRD.
• To identify the common causes of renal failure and complications in pediatric kidney transplant recipients.
• To assess the immunosuppressive strategies employed in pediatric kidney transplantation.

Main Methods:

• Retrospective case series study involving pediatric patients with ESRD undergoing kidney transplantation.
• Data collected from two centers in Sulaymaniyah between 2015 and 2021.
• Analysis of patient demographics, etiology of renal failure, surgical procedures, immunosuppression, and complications.

Main Results:

• The study included 39 male and 13 female pediatric patients; donors were predominantly males aged 25-40.
• The majority of recipients were adolescents aged 15-18 years.
• Reflux nephropathy was the most common cause of renal failure; Thymoglobulin was the primary induction immunosuppressant.
• Artery anastomosis was typically performed to the external iliac artery.
• Complications occurred in 9 patients, with 3 experiencing acute rejection.

Conclusions:

• Renal transplantation is the preferred treatment for pediatric end-stage renal disease in Sulaymaniyah.
• Reflux nephropathy is the leading cause of pediatric renal failure in this region, differing from North American studies.
• Living donor kidney transplantation demonstrates feasibility and efficacy in the pediatric population studied.