Outcome of renal transplantation in children less than two years of age

• Published in: Kidney international Vol. 42; no. 3; pp. 657 - 662
• Main Authors: Briscoe, David M., Kim, Melanie S., Lillehei, Craig, Eraklis, Angelo J., Levey, Raphael H., Harmon, William E.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-09-1992; Nature Publishing
• Subjects: Adolescent; Biological and medical sciences; Cadaver; Child; Child, Preschool; Female; Graft Rejection; Graft Survival; Humans; Infant; Infant, Newborn; Kidney Transplantation - methods; Kidney Transplantation - mortality; Male; Medical sciences; Postoperative Period; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Survival Analysis; Tissue Donors; Human; Prognosis; Infant; Transplantation; Homotransplantation; Epidemiology; Long term; Survival; Kidney; Rejection; Treatment; Urinary system; Donor; Surgery; Complication; Graft; Comparative study
• ISSN: 0085-2538; 1523-1755
• DOI: 10.1038/ki.1992.331

Outcome of renal transplantation in children less than two years of age. Twenty-two renal transplants were performed in 21 children less than two years of age at Children's Hospital. Fourteen were from living related donors and eight were from cadaveric donors. The five year patient and graft survivals of these recipients were compared to all other pediatric recipients between two and 18 years of age who received renal transplants over the same time period. Five year graft survival for recipients less than two years of age was 86% following living-related donor transplantation and 38% following cadaver donor transplantation. Older pediatric recipients aged between two and 18 years had a five year graft survival of 73% following living-related donor renal transplantation, which was similar to that for recipients less than two years of age. Although older cadaveric recipients had a comparable five year graft survival to younger recipients, at 42%, the patterns of graft loss were different. Graft failures in young recipients occurred within the first seven months post-transplant, whereas the older recipient's grafts failed more gradually. Actuarial five-year patient survival in recipients less than two years of age was 86% following living-related donor renal transplantation and 70% following cadaver-donor renal transplantation. Recipients less than two years of age had a poorer patient survival than older recipients following both living-related donor renal transplantation (P = 0.06) and cadaver-donor renal transplantation (P < 0.05). These findings suggest that the graft survival of living-related donor renal transplantation in recipients less than two years of age is better than that of cadaver-donor renal transplantation. Furthermore, graft survival of living-related donor renal transplantation in children less than two years of age is the same as that in older children, although patient survival in the younger group may be slightly decreased.