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Outcome of cadaver kidney transplantation in small children
Author(s) -
Cochat Pierre,
Castelo Fernanda,
Glastre Catherine,
Martin Xavier,
Stamm Didier,
Long Denise,
Lavocat MariePierre,
HadjAïssa Aoumeur,
Lyonnet Denis,
Floret Daniel
Publication year - 1994
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1994.tb12957.x
Subject(s) - medicine , surgery , transplantation , anastomosis , peritoneal dialysis , kidney transplantation , immunosuppression , dialysis , prednisone , azathioprine , perioperative , disease
Cochat P, Castelo F, Glastre C, Martin X, Stamm D, Long D, Lavocat M‐P, Hadj‐Aïssa A, Lyonnet D, Floret D. Outcome of cadaver kidney transplantation in small children. Acta Pædiatr 1994;83:78–83. Stockholm. ISSN 0803–5253 Small children have often been reported to have poor outcome after kidney transplantation (KT). Recent reports from North America have shown that the use of living‐related donors improves patient and graft survival. We report the experience in one centre of primary cadaveric KT using sequential immunosuppression in nine children aged 8–30 months and weighing 5.4–9.8 kg; donors were 0.7–12.3 years old. Four patients had pre‐emptive KT and the other five were on peritoneal dialysis; the mean ± SD waiting time was 2.0 ± 2.4 months. Perioperative care has been published previously. The surgical approach was intraperitoneal if the aorta and vena cava were used ( n = 7) and extraperitoneal for common iliac vessels anastomosis ( n = 2); the duration of surgery was 3.5 ± 0.9 h and the time for vascular anastomosis was 32 ± 6 min. The recipients received ATG, azathioprine, prednisone and delayed administration of cyclosporin A. The patients were followed for 12–98 (median 41) months and showed good graft function (inulin clearance 63–100 ml/min/1.73 m 2 ); only one child with recurrent haemolytic uraemic syndrome lost his graft three months post‐transplantation and died after he had received a second graft. None of the recipients required post‐transplant dialysis; arterial hypertension involved four children and was related to graft artery stenosis in two. Growth improved by 0.24 ± 0.48 SD score of height per year. Compared to earlier reports on cadaver transplantation in small children (about 40% graft survival after five years) and to the outcome of chronic peritoneal dialysis, the present results are better and appear to be similar to those obtained with living‐related donor transplantation.