Long‐term outcome of pediatric renal transplantation: a single center experience

Abe T, Ichimaru N, Kakuta Y, Okumi M, Imamura R, Isaka Y, Takahara S, Kokado Y, Okuyama A. Long‐term outcome of pediatric renal transplantation: a single center experience.
Clin Transplant 2011: 25: 388–394. © 2010 John Wiley & Sons A/S. Abstract: Renal transplantation is the optimal treatment for pediatric end‐stage renal disease. We examined 51 children <20 yr old who underwent a total of 52 living‐donor renal transplantations at Osaka University Hospital between 1972 and 2004. The mean age at transplantation was 13.7 (3–19 yr). The mean duration of follow‐up was 16.5 yr. The five‐, 10‐, and 20‐yr patient survival rates following renal transplantation were 94%, 90%, and 87%, respectively. The five‐, 10‐, and 20‐yr graft survival rates were 76%, 65%, and 48%, respectively. A double‐drug regimen was used before 1987; this was replaced by a triple‐drug regimen including a calcineurin inhibitor in 1988. The five‐, 10‐, and 20‐yr graft survival rates after 1988 (89%, 80%, and 60%, respectively) were higher than those before 1987. Growth was examined among patients <15 yr old at the time of surgery, and height standard deviation (SD) scores (Z‐scores) were analyzed in 14 patients who displayed favorable renal function after transplantation. At the time of transplantation, mean SD score (SDS) was ?2.39, and mean final adult SDS was ?1.79. Rates of patient and graft survival after renal transplantation were mostly favorable. Future goals must include overcoming chronic rejection and establishing a steroid discontinuation protocol to improve growth.