Renal transplantation in children less than 2 years of age

We report our experience with renal transplantation in ten infants receiving grafts at ages 1 to 21 months. All children were followed for at least six months posttransplantation, except two who died in the immediate postoperative period. Kidneys were obtained from cadaveric donors: four from anencephalic newborn infants and eight others from donors aged 9 months to 21 years at death. Immunosuppressive therapy consisted of prednisone, azathioprine, and antithymocyte globulin, with added doses of methylprednisolone for rejection. Patient survival at six months was 8/10, at two years 3/7 (three patients who were alive but were followed for less than two years are excluded), and at present 5/10. Graft survival at six months was 5/10, at two years 2/12, and at present 1/12. Cadaveric renal transplantation in small children is technically feasible, but the enormous time and effort involved in such an undertaking must be re-evaluated.