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Published on: July 19, 2021
Renal Transplantation in Pediatric Patients: Surgical Outcomes of 15 Years of Single-Center Experience
Hakan Sözen1, Ramazan Kozan, Behruz Hüseyn
1>From Transplantation Center, Gazi University Medical School, Ankara, and the Department of Surgery, Gazi University Medical School, Ankara, Türkiye.
Insights
Pediatric renal transplantation is a safe procedure with acceptable outcomes. This 15-year study found no graft loss from surgical complications, though infections and rejections occurred.
Area of Science:
- Nephrology
- Pediatric Surgery
- Transplantation Medicine
Background:
- End-stage renal failure necessitates renal transplant for pediatric patients.
- Renal transplantation offers the most effective treatment for end-stage renal disease in children.
- Gazi University Transplantation Center has extensive experience in pediatric kidney transplantation.
Purpose of the Study:
- To evaluate the outcomes of pediatric kidney transplants over a 15-year period.
- To assess the safety and efficacy of pediatric renal transplantation.
- To analyze complications, graft survival, and patient survival in pediatric kidney transplant recipients.
Main Methods:
- Retrospective analysis of 51 pediatric kidney transplants performed between January 2006 and January 2021.
- Data collected from hospital medical records of pediatric transplant recipients.
- Evaluation of graft survival, patient survival, complications, and infections.
Main Results:
- Kidney grafts were sourced from 33 living (65%) and 18 deceased (35%) donors.
- 19.6% of pediatric transplants experienced complications, primarily surgical (9.8%) and urologic (1.9%).
- Graft survival was 45.1% at 15 years, with 27.4% experiencing acute rejection and 29.4% developing infections.
Conclusions:
- Pediatric renal transplantation is a safe procedure at Gazi University Transplantation Center.
- Outcomes align with those reported in other international series.
- No graft loss was attributed to surgical complications, highlighting procedural safety.
Objectives:
Renal transplant is the most appropriate treatment for adult and pediatric patients with end-stage renal failure.
Materials And Methods:
Fifty-one pediatric kidney transplants were performed in 49 pediatric recipients from a total of 263 kidney recipients at the Gazi University Transplantation Center (Türkiye) between January 2006 and January 2021. We gathered and analyzed data retrospectively from hospital medical records of pediatric transplant recipients.
Results:
Kidney grafts were obtained from 18 deceased (35%) and 33 living donors (65%). Among 51 pediatric renal transplants, 10 (19.6%) had complications, with 6 early and 4 late complications. Among 6 early complications posttransplant, 5 were surgical complications (9.8%) and 1 (1.9%) was urologic (1.9%), but no vascular complications were seen. Among 5 surgical complications, 3 (5.8%) were lymphocele and 2 were (3.9%) bleeding complications. Among 4 patients with late complications, 2 had renal artery stenosis and 2 had ureter stenosis. Two patients required re-transplantation because of graft loss from BK virus nephropathy and chronic allograft nephropathy. Among 51 pediatric kidney transplants, 15 recipients (29.4%) presented with 27 cases of infection. Twenty-one acute rejection episodes were seen in 14 of 51 pediatric transplant procedures (27.4%), and 4 humoral rejections occurred in 3 of 51 pediatric transplant procedures (5.8%). In addition, 27 renal transplant patients (52.9%) had normal graft functions at median follow-up of 95 months (98.7 ± 57.7; range, 58-233 mo). Twenty-eight of 51 patients (54.9%) lost kidney grafts over a 15-year follow-up. No graft loss or patient deaths occurred because of surgical complications.
Conclusions:
In analysis of 15 years of experience in pediatric renal transplants, our results were within results of other series. Pediatric renal transplant is a safe procedure in our department, based on patient and graft survivals, with no graft loss from surgical complications.
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