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[Clinical study of pediatric kidney transplantation at Kansai]
S Kunikata1, T Akiyama, T Kurita
1Department of Urology, Kinki University of Medicine, Japan.
Background:
The clinical study of pediatric kidney transplantation in Kansai area is reported in this paper.
Methods:
Seventy six children, 0-15 years old, received renal transplants at 8 transplant centers of Kansai area up to December, 1993. Clinical study was carried out about the etiology of renal failure causes, the graft survival and the complications.
Results:
End-stage renal failure was due to a variety of diseases. The 3 most common causes were chronic glomerulonephritis, chronic pyelonephritis including of reflux nephropathy and focal segmental glomerulosclerosis (FSGS). The graft rates at 3, 5 and 8 years were 75%, 71% and 53% for children receiving azathioprine (AZ), compared to 77%, 59% and 52% for ones receiving ciclosporin (Cs). Cs has led no improvement of the graft survival. Adult had the better graft survival rate than children in Cs immunosuppressive protocol. In 12 children transplanted kidneys for FSGS, only 3 cases had recurrent FSGS. Neoplasia was found in two case. They were acute leukemia and liposarcoma.
Conclusion:
Kidney transplantation is recommended as the treatment for end-stage FSGS. Even the children should be carefully followed up after transplantation for malignant tumors.