Kidney transplantation in children: a single center experience of 105 cases

Abstract

Objective To analyze the clinical features and outcome of pediatric kidney transplantation, and to explore the related clinical issues. Method The clinical data of 105 pediatric kidney transplants from 1990 to 2015 were retrospectively analyzed. There were 99 cases of primary transplantation and 6 cases of secondary transplantation. There were 3 cases of combined liver-kidney transplantation. The youngest recipient was 3 years old. The median age of pediatric recipients was 14.3 years old. There were 42, 18 and 45 cases of kidney transplantation from conventional deceased donor, living-related donor and donation after citizen's death (DCD), respectively. Result The patient and graft survival rate at 1, 3, 5 and 10 years post-transplant was 96.1%/92.1%, 91.8%/86.6%, 90.0%/84.1%, and 90.0%/76.4%, respectively. There was no significant difference in either patient or graft survival among pediatric kidney transplants from living donors, conventional deceased donors, or DCD. Five out of 8 deaths (62.5%) were closely related to the recipients' comorbidities prior to kidney transplantation. The most common complications at early stage after transplantation were infection (23.8%) and acute rejection (16.2%). Conclusion Kidney transplantation provides good short-term and long-term outcome for children with renal failure. DCD has become a main donor source for pediatric recipients. One should pay special attention to potential congenital or inherited comorbidities when estimating transplant indications for children. Key words: Kidney transplantation; Child; Nephritis; Nephrosis; Survival rate