The effect of cyclosporine on mortality and renal function in living related pediatric kidney transplant recipients |
| |
Authors: | Norio Yoshimura MD Takahiro Oka Yoshihiro Ohmori Ichiro Aikawa Masatake Fukuda Tadaki Yasumura Ichiro Nakai Suguru Matsui Chol Joo Lee Takashi Hamashima |
| |
Institution: | (1) The Second Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kawaramachi, Hirokoji, Kamigyo-ku, 602 Kyoto City, Kyoto, Japan |
| |
Abstract: | The outcome, incidence of acute rejection episodes, complications and cyclosporine (CyA) induced nephrotoxicity were studied
in 10 pediatric kidney transplant recipients who were grafted from one-haplotype indentical parent with immunosuppression
of CyA and prednisolone (Pred). Excellent patient and graft survival could be achieved in this population with low incidences
of acute rejection or serious complications as when compared with the results of azathioprine (AZ) treated pediatric patients.
With a mean follow-up of 12.9 months (range 1 to 50 months), the patient survival rate was 100 per cent and the graft survival
rate was 100, 84, 84 and 84 per cent at 1, 2, 3 and 4 years post transplantation, respectively. Serum creatinine levels in
the group were 0.97, 1.17, 1.14 and 1.2 mg/dl at 3, 6, 12 and 24 months post transplantation, respectively. The incidence
of treated acute rejection episodes was 20 per cent (2 out of 10) in the CyA-treated children, whereas it was 53 per cent
(9 of 17) in the Az-treated children. Five children who had undergone transplant surgery before they were 11 years old displayed
linear growth in height after their transplantation. There have been no opportunistic infections, aseptic necrosis or peptic
ulcers in this group and cyclosporine nephrotoxicity has not been a serious problem in the pediatric recipients. Only 10 per
cent (1 out of 10) of the recipients displayed acute nephrotoxicity and only one recipient has converted from CyA+Pred to
CyA+AZ+Pred (Three drug therapy) due to persistent nephrotoxicity. Cyclosporine and prednisolone have therefore constituted
a relatively safe, effective immunosuppressive regimen for pediatric renal allograft recipients.
This paper was presented at the 7th international congress of pediatric nephrology. |
| |
Keywords: | cyclosporine pediatric kidney transplantation nephrotoxicity |
本文献已被 SpringerLink 等数据库收录! |
|