Year: 2018
Type: article
Study design: Observational Study
Abstract: INTRODUCTION AND AIMS: Renal transplantation is the modality of the choice for the management of children with end stage renal disease. It offers better quality of life and is associated with lower mortality risk than dialysis. Pediatric kidney transplantation has satisfactory outcome, though associated with risk of rejection and infection.This study was carried out to evaluate (1) the outcome of pediatric renal transplant over the last 10 yrs (2) the incidence of infection and rejection in these patients. METHODS: This is a retrospective review of patients upto 18 years of age who underwent renal transplant at Fortis Institute of Renal Sciences and Transplantation, Fortis hospitals, India from 2006 to 2017. Data on age, sex, use of immunosuppression, incidence of infection and rejection was collected. Percentage, range and median were used to represent the data. RESULTS: Total 87 pediatric patients underwent renal transplant between 2006-2017 at Fortis hospitals. Median age was 15 years (3-18 years) and there were 57 boys and 30 girls. The imunosuppresion protocol consisted of induction by eithe rbasiliximab or ATG, followed bymantainence immunosuppressionwith tacrolimus, mycophenolate and steroids. 19 patients received no induction. Median creatinine at the time of discharge was 0.79 mg/dl (0.3-1.6 mg/dl). The median duration of follow up was 49 months (1-132 months). In our cohort, patient survival rate was 97% and graft survival rate was 92%. Ten patients had infections - UTI (3),TB(1), varicella (1), cryptosporidium diarrhea(1), BK virus (1)and CMV (3)infections. Rate of rejectionwas14.3%. Two patient had a graft loss in the early post operative period, one secondary to renal vein thrombosis and other due to BK virus infection/acute tubular necrosis.Five patients lost the graft over the next 5 years due to non compliance with medications (3 patients), recurrence of FSGS (1 patient) and cause not known for one patient. 2 patients died with functioning graft, one due to severe pancreatitis and other due to severe sepsis.One died after return to dialysis. CONCLUSIONS: Outcomes of renal transplantation in children have improved overthe last decade. Compliance with medications and regular follow up are the major contributors for satisfactory long-term outcome.
Authors: Sanjeev Gulati, Rachita Dhull, Manoj Singhal, Alok Jain, Rajeev Sinha, Vishal Saxena
Institutions: Fortis Healthcare, Fortis Hospital, Fortis Hospital, Fortis Hospital
Language: English
Subfield: Transplantation
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funder: NIH Clinical Center
OpenAlex ID: W2803985960