Medical and surgical aspects of pediatric renal transplantation using living donors

Transplant Proc. 2004 Jun;36(5):1308-10. doi: 10.1016/j.transproceed.2004.05.080.

Abstract

The outcomes of 19 consecutive living-donor renal transplants (LD-RTx) was compared with 41 cadaveric grafts (CD-RTx) performed at our institution using basiliximab, cyclosporine, and prednisone as standard immunosuppression. LD-RTx significantly shortened the waiting time on dialysis. However, patient survival (100% in both groups), 1-year graft survival (94.7% vs 90%), and rejection-free graft survival (76.9% vs 73.5%) was not significantly different. LD-RTx showed better glomerular filtration rates in the early phase after transplantation, a difference that faded with time. Graft function was similar after 1 and 2 years. LD grafts with double renal arteries were used successfully in four cases; heparin therapy was administered to avoid graft thrombosis. A significantly greater number of lymphoceles was observed with LD grafts (7/19 vs 1/41, P < .01). In conclusion with improved immunosuppression producing better results with CD grafts, the advantages of LD-RTx have vanished. LD grafts with double arteries may be used successfully and LD-RTx allows a shorter dialysis period. The high incidence of lymphoceles in our series awaits further evaluation.

MeSH terms

  • Child
  • Female
  • Graft Survival / physiology
  • Humans
  • Kidney Transplantation / mortality
  • Kidney Transplantation / physiology*
  • Living Donors*
  • Male
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome