Pediatric renal transplantation: results and prognostic factors

Asian J Surg. 2013 Apr;36(2):53-7. doi: 10.1016/j.asjsur.2012.09.001. Epub 2012 Oct 23.

Abstract

Background/objective: As renal transplantation may increase survival rates and improve quality of life for children with end-stage renal disease, we investigated the long-term outcomes and prognostic factors of pediatric renal transplantation.

Methods: A retrospective study was conducted to review 25 pediatric renal transplantations, either from live or deceased donors, in our hospital from 1995 to 2008. The cumulative graft survival rate was calculated using the Kaplan-Meier method. Log rank tests were employed to identify categorical prognostic factors for graft survival of the pediatric renal transplantations, and Cox regression analysis for numeric factors.

Results: The mean age of our study subjects was 11.63±3.76 years, and the mean follow-up period was 49.24±33.72 months. The 12-month and 36-month graft survival rates were 92% and 82.14%, respectively. The rejection-free survival rates were 88% and 72.88% in the first and third years, respectively. All of the patients were alive during the follow-up period. Acute rejection (p=0.0175) and male sex (p=0.0384) were found to be significant factors for graft survival.

Conclusion: For pediatric patients, we found that renal transplantation is now a safe and effective surgical procedure for children with end-stage renal disease. Acute rejection and male gender were identified as prognostic factors for poor graft survival.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Graft Rejection / epidemiology
  • Graft Survival
  • Humans
  • Infant
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation*
  • Male
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Treatment Outcome