Abstract
Objective: This study aims to determine surgical complications and graft outcome in children undergoing renal transplantation at Cayetano Heredia National Hospital (CHNH). Materials and Methods: A case study series focused on the incidence of surgical complications and graft outcome in pediatric patients with end stage renal disease (ESRD) who underwent renal transplant (RT) between December 2007 and March 2011. Results: The study described 29 pediatric transplant patients whose average age was 13.69 ± 3.38 (6.2-17.9) years. The etiology of end stage renal disease (ESRD) was renal hypoplasia in 12 patients (41.38%), primary glomerulopathy in 10 patients (34.48%), obstructive uropathy in 4 patients (13.79%), vasculitis in 2 patients (6.9%) and hemolytic uremic syndrome (HUS) in 1 (3.45%) patient. There were 11 surgical complications (34.48%): 2 cases of arterial thrombosis, 3 cases of urinary fistula, 3 of lymphocele, 1 of venous thrombosis, urinoma and perineal collection. The follow-up time was 15.84 ± 12.19 months. Graft survival at 12, 24, and 40 months was 89.29%, 77.16% and 77.16%, respectively. Conclusion: Surgical complications and graft survival in pediatric renal transplantation in our series did not differ from other published series.
Highlights
end stage renal disease (ESRD), defined as a permanent loss of the kidneys’ ability to filter waste from the circulatory system, is a global public health problem of growing proportions [1]
This study aims to determine surgical complications and graft outcome in children undergoing renal transplantation at Cayetano Heredia National Hospital (CHNH)
The etiology of end stage renal disease (ESRD) was renal hypoplasia in 12 patients (41.38%), primary glomerulopathy in 10 patients (34.48%), obstructive uropathy in 4 patients (13.79%), vasculitis in 2 patients (6.9%) and hemolytic uremic syndrome (HUS) in 1 (3.45%) patient
Summary
ESRD, defined as a permanent loss of the kidneys’ ability to filter waste from the circulatory system, is a global public health problem of growing proportions [1]. Surgical techniques, and the discovery of immunosuppressants have allowed a progressive reduction in the contraindications to this procedure, even though the biological behavior and potential complications in transplanted children differ to those in adults [4,9,10]. Surgical complications affect survival and renal graft loss, so early diagnosis and prompt treatment are important. Surgical complications in renal transplantation are defined as complications that occur during surgery and the postoperative follow-up. They are classified as vascular, urological, and collections and have an incidence ranging from 1% to 38% [9,10,11,12,13,14,15]. Augusto Hernandez Mendoza, a urologist, performed the first RT, and followed by Raul Romero Torres, who established the transplant unit at the Naval Medical Center
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