Cadaver donor kidney retransplantation in the pediatric patient: complications and long-term outcome

J Urol. 2011 Jun;185(6 Suppl):2582-5. doi: 10.1016/j.juro.2011.01.028. Epub 2011 Apr 27.

Abstract

Purpose: We compared the outcome of second and third kidney allografts with that of the first kidney allograft in pediatric recipients.

Materials and methods: We classified 173 cadaveric kidney recipients into 2 groups. Group 1 comprised 120 first transplants and group 2 comprised 53 retransplants, including 43 second and 10 third transplants. We compared demographic characteristics and survival in groups 1 and 2.

Results: Group 1 consisted of 78 boys and 42 girls with a mean ± SD age of 11.5 ± 4.2 years. Group 2 consisted of 37 boys and 16 girls with a mean age of 10.4 ± 4.7 years. One, 5, 10 and 15-year graft survival rates were 78.7%, 64.3%, 54.5% and 50.7% for first transplants vs 82.8%, 57.8%, 57.8% and 41.3%, respectively, for retransplants (p = 0.757). Patient survival at 1, 5 and 15-year was 95.8%, 89.6%, 84.9% in the first transplant group vs 93.6%, 93.6% and 93.6%, respectively, in the retransplant group (p = 0.0.63). Graft survival was significantly higher in patients who did vs did not receive calcineurin inhibitors in the 2 groups (p = 0.02).

Conclusions: Kidney retransplantation in the pediatric population can yield excellent long-term outcomes, especially in patients treated with calcineurin inhibitors.

MeSH terms

  • Adolescent
  • Adult
  • Cadaver
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retreatment
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Tissue Donors*
  • Treatment Outcome
  • Young Adult