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Title
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Outcomes of kidney transplantations in children weighing 15 kilograms or less : a retrospective cohort study
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Author
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Abstract
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| Kidney transplantation (KT) is often delayed in small children because of fear of postoperative complications. We report early- and long-term outcomes in children transplanted at 15 kg in the two largest Belgian pediatric transplant centers. Outcomes before (period 1) and since the introduction of basiliximab and mycophenolate-mofetil in 2000 (period 2) were compared. Seventy-two KTs were realized between 1978 and 2016: 38 in period 1 and 34 in period 2. Organs came from deceased donors in 48 (67%) cases. Surgical complications occurred in 25 KTs (35%) with no significant difference between the two periods. At least one acute rejection (AR) occurred in 24 (33%) KTs with significantly less patients experiencing AR during period 2: 53% and 12% in period 1 and, period 2 respectively (P < 0.001). Graft survival free of AR improved significantly in period 2 compared with period 1: 97% vs. 50% at 1 year; 87% vs. 50% at 10 years post-KT (P = 0.003). Graft survival tended to increase over time (period 1: 74% and 63% at 1 and 5 years; period 2: 94% and 86% at 1 and 5 years; P = 0.07), as well as patient survival. Kidney transplantation in children 15 kg remains a challenging procedure with 35% of surgical complications. However, outcomes improved and are nowadays excellent in terms of prevention of AR, patient and graft survival. |
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Language
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English
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Source (journal)
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Transplant international. - Heidelberg, 1988
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Publication
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Heidelberg
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2018
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ISSN
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0934-0874
[print]
1432-2277
[online]
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DOI
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10.1111/TRI.13108
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Volume/pages
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31
:7
(2018)
, p. 720-728
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ISI
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000434987600007
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Pubmed ID
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29281761
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Full text (Publisher's DOI)
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Full text (open access)
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Full text (publisher's version - intranet only)
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