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• W2161362708 abstract "No AccessJournal of UrologyPediatric Urology1 Jun 1999KIDNEY TRANSPLANTATION IN CHILDREN: A SINGLE CENTER EXPERIENCE DAVID B. LASHLEY, JOHN M. BARRY, ANGELO M. DEMATTOS, MARC B. LANDE, and JEANNE A. MOWRY DAVID B. LASHLEYDAVID B. LASHLEY More articles by this author , JOHN M. BARRYJOHN M. BARRY More articles by this author , ANGELO M. DEMATTOSANGELO M. DEMATTOS More articles by this author , MARC B. LANDEMARC B. LANDE More articles by this author , and JEANNE A. MOWRYJEANNE A. MOWRY More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)68853-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We reviewed our most recent 10-year experience with kidney transplantation in children to determine the morbidity and mortality of the procedure, and to identify factors that affected outcome. Materials and Methods: A total of 107 renal transplants were done in 95 children 1 to 17 years old (mean age 10.9) during the 10-year period ending January 1, 1997. The 4 most common causes of end stage renal disease were renal dysplasia, reflux nephropathy, obstructive uropathy and systemic immunological diseases. Cyclosporine based immunosuppression was used in all but 2 recipients. After April 1991 antilymphocyte antibody induction, coagulopathy screening, systemic anticoagulation and cytomegalovirus prophylaxis were incorporated into the protocols. The effects of kidney source, recipient gender, recipient age, preformed anti-HLA antibody level, preemptive renal transplantation, cytomegalovirus risk, antilymphocyte antibody induction therapy and date of renal transplantation on kidney graft survival were examined with the log rank test. Results: The 1-year graft and patient survival rates were 91 and 99%, respectively. The most common causes of graft failure were rejection and recurrence of primary renal disease. The only factors that significantly (p <0.05) influenced graft survival were antilymphocyte antibody induction immunosuppression and kidney transplantation after April 1991. Three urological complications required surgical correction. Medical morbidity included hypertension in 48.6% of the cases, short stature in 46.6% and obesity in 58.9%. Conclusions: Pediatric renal transplantation can be done with acceptable morbidity, a low rate of technical complications and low mortality. Hypertension, chronic rejection and abnormal body habitus continue to be problematic. References 1 : Kidney transplant between identical twins. J. Urol.1963; 89: 115. Link, Google Scholar 2 : Renal transplantation. In: . Philadelphia: W. B. Saunders Co.1998: 505. chapt. 14. Google Scholar 3 Barry, J.M., Reller, K.S., Lande, M.B., Mowry, J.A., Jenkins, R.: The transplantation of adult kidneys into small children. 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Daclizumab Triple Therapy Study Group. New Engl. J. Med.1998; 338: 161. Google Scholar 17 : Cytomegalovirus infections following transplantation-effects of antiviral prophylaxis: a report of the North American Pediatric Renal Transplant Co-operative Study. Ped. Nephrol.1997; 11: 665. Google Scholar 18 : Unstented extravesical ureteroneocystostomy in kidney transplantation. J. Urol.1983; 129: 918. Link, Google Scholar 19 : Urological complications in pediatric renal transplantation: management and prevention. J. Urol.1988; 140: 1123. Link, Google Scholar 20 : Complications of surgical significance in pediatric renal transplantation. J. Ped. Surg.1992; 27: 485. Google Scholar 21 : Bladder augmentation can be problematic with renal failure and transplantation. Ped. Nephrol.1997; 11: 672. Google Scholar 22 : Extended recombinant human growth hormone treatment after renal transplantation in children. J. Amer. Soc. Nephrol.1992; 2: S274. Google Scholar 23 : Efficacy and safety of growth hormone treatment in short children with renal allografts: three year experience. Members of the German Study Group for Growth Hormone Treatment in Children with Renal Allografts. Kidney Int.1993; 44: 199. Google Scholar 24 : The role of growth hormone in modulation of the immune response. Ann. N.Y. Acad. Sci.1990; 594: 95. Google Scholar From the Divisions of Urology and Renal Transplantation, Nephrology and Pediatric Nephrology, Oregon Health Sciences University, Portland, Oregon© 1999 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byJahromi M, Velasquez M, Blachman-Braun R, Gosalbez R, Castellan M, Labbie A, Ciancio G, Chandar J and Alam A (2019) Pediatric Kidney Transplantation Outcomes in Children with Primary Urological Abnormalities Versus Nonurological Abnormalities: Long-Term ResultsJournal of Urology, VOL. 203, NO. 2, (406-412), Online publication date: 1-Feb-2020.Pirker M, Colhoun E and Puri P (2018) Renal Scarring in Familial Vesicoureteral Reflux: Is Prevention Possible?Journal of Urology, VOL. 176, NO. 4S, (1842-1846), Online publication date: 1-Oct-2006.FURNESS P, HOUSTON J, GRAMPSAS S, KARRER F, FIRLIT C and KOYLE M (2018) EXTRAPERITONEAL PLACEMENT OF RENAL ALLOGRAFTS IN CHILDREN WEIGHING LESS THAN 15 KG.Journal of Urology, VOL. 166, NO. 3, (1042-1045), Online publication date: 1-Sep-2001. Volume 161Issue 6June 1999Page: 1920-1925 Advertisement Copyright & Permissions© 1999 by American Urological Association, Inc.MetricsAuthor Information DAVID B. LASHLEY More articles by this author JOHN M. BARRY More articles by this author ANGELO M. DEMATTOS More articles by this author MARC B. LANDE More articles by this author JEANNE A. MOWRY More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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