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The challenges and outcomes of living donor kidney transplantation in pediatric and adolescent age group in a developing country: A critical analysis from a single center of north India.

Srivastava A, Prabhakaran S, Sureka SK, Kapoor R, Kumar A, Sharma RK, Prasad N, Ansari MS - Indian J Urol (2015 Jan-Mar)

Bottom Line: The 1, 3 and 5 year graft survival rates were 94.3%, 89.2% and 66.8%, respectively.The overall survival rates were 95.7%, 96.4% and 94.1% for 1, 3 and 5 years, respectively.Early graft survival is comparable, but the 5-year graft survival is clearly inferior as compared with developed countries.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

ABSTRACT

Introduction: Renal transplantation is the treatment of choice for children with end-stage renal disease (ESRD). We evaluated the outcome of renal transplantation in the pediatric and adolescent age groups in the perspective of a developing country as compared with developed nations while highlighting the challenges we have faced in a pediatric transplant programme.

Materials and methods: Seventy live related pediatric and adolescent renal transplantations were reviewed retrospectively. Variables analyzed were etiology of ESRD, pre-transplant renal replacement modality, donor relationship, surgical complications, rejection episodes, immuno-suppression regimens, compliance to immunosuppression, graft survival and overall survival.

Results: The cohort consisted of 13 (18%) female and 57 male (82%) recipients. The mean age was 14 ± 1.4 years. The etiology of ESRD was chronic glomerulonephritis (n = 43), chronic interstitial nephritis (n = 26) and Alport's syndrome (n = 1). Fifty-six (80%) children were on hemo-dialysis and 10 (14%) on peritoneal dialysis prior to transplantation. 80.5% and 61% patients were strictly compliant to immunosuppresant medications at 1 and 5 years. The 1, 3 and 5 year graft survival rates were 94.3%, 89.2% and 66.8%, respectively. The overall survival rates were 95.7%, 96.4% and 94.1% for 1, 3 and 5 years, respectively.

Conclusions: The spectrum of etiology of ESRD differs in our patients from the west, with chronic glomerulonephritis being the most common etiology. Early graft survival is comparable, but the 5-year graft survival is clearly inferior as compared with developed countries.

No MeSH data available.


Related in: MedlinePlus

Graft survival curve
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Figure 1: Graft survival curve

Mentions: The 1, 3 and 5 year graft survival rates were 94.3%, 89.2% and 66.8%, respectively [Figure 1]. The graft survival was comparable in laparoscopic versus open donor nephrectomy (P = 0.62) and single versus multiple renal arteries in the donor kidney (P = 0.67). The overall patient survival was 95.7%, 96.4% and 94.1% for 1, 3 and 5 years, respectively.


The challenges and outcomes of living donor kidney transplantation in pediatric and adolescent age group in a developing country: A critical analysis from a single center of north India.

Srivastava A, Prabhakaran S, Sureka SK, Kapoor R, Kumar A, Sharma RK, Prasad N, Ansari MS - Indian J Urol (2015 Jan-Mar)

Graft survival curve
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4300569&req=5

Figure 1: Graft survival curve
Mentions: The 1, 3 and 5 year graft survival rates were 94.3%, 89.2% and 66.8%, respectively [Figure 1]. The graft survival was comparable in laparoscopic versus open donor nephrectomy (P = 0.62) and single versus multiple renal arteries in the donor kidney (P = 0.67). The overall patient survival was 95.7%, 96.4% and 94.1% for 1, 3 and 5 years, respectively.

Bottom Line: The 1, 3 and 5 year graft survival rates were 94.3%, 89.2% and 66.8%, respectively.The overall survival rates were 95.7%, 96.4% and 94.1% for 1, 3 and 5 years, respectively.Early graft survival is comparable, but the 5-year graft survival is clearly inferior as compared with developed countries.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology and Renal Transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

ABSTRACT

Introduction: Renal transplantation is the treatment of choice for children with end-stage renal disease (ESRD). We evaluated the outcome of renal transplantation in the pediatric and adolescent age groups in the perspective of a developing country as compared with developed nations while highlighting the challenges we have faced in a pediatric transplant programme.

Materials and methods: Seventy live related pediatric and adolescent renal transplantations were reviewed retrospectively. Variables analyzed were etiology of ESRD, pre-transplant renal replacement modality, donor relationship, surgical complications, rejection episodes, immuno-suppression regimens, compliance to immunosuppression, graft survival and overall survival.

Results: The cohort consisted of 13 (18%) female and 57 male (82%) recipients. The mean age was 14 ± 1.4 years. The etiology of ESRD was chronic glomerulonephritis (n = 43), chronic interstitial nephritis (n = 26) and Alport's syndrome (n = 1). Fifty-six (80%) children were on hemo-dialysis and 10 (14%) on peritoneal dialysis prior to transplantation. 80.5% and 61% patients were strictly compliant to immunosuppresant medications at 1 and 5 years. The 1, 3 and 5 year graft survival rates were 94.3%, 89.2% and 66.8%, respectively. The overall survival rates were 95.7%, 96.4% and 94.1% for 1, 3 and 5 years, respectively.

Conclusions: The spectrum of etiology of ESRD differs in our patients from the west, with chronic glomerulonephritis being the most common etiology. Early graft survival is comparable, but the 5-year graft survival is clearly inferior as compared with developed countries.

No MeSH data available.


Related in: MedlinePlus