Pediatric and adult renal transplants: a comparative study

In order to compare the results of renal transplantation in pediatric and adult recipients, a retrospective analysis of first transplants done at a single institution over a 6-yr period was carried out. The study included 21 pediatric and 196 adult recipients of cadaveric grafts, and 18 pediatric and 156 adult recipients of living related grafts. Pediatric and adult recipient groups were shown to be similar to each other with respect to donor-recipient HLA antigen matching and to causes of graft failure and patient mortality. Actuarial graft and patient survival data for pediatric recipients was found to be better than for the corresponding adult recipient groups, although the differences were not statistically significant. When clinical results, technical problems, and psychosocial adaptation are considered critically, transplantation is clearly preferable to both hemodialysis and to no treatment for pediatric patients with end stage renal disease (ESRD). There is a considerable discrepancy between the estimated incidence of ESRD in children and the number of children being tranplanted for this disease. Many patients are, therefore, receiving less than optimum treatment. Efforts to correct this discrepancy are in order.