Kidney transplantation in children weighing less than 15 kg: Extraperitoneal surgical access–experience with 62 cases

Vitola, Santo Pascual; Gnatta, Diego; Garcı́a, Valter Duro; Garcia, Clotilde Druck; Bittencourt, V.; Keitel, Elizete; Pires, F.; D’Ávila, André Ricardo; Silva, J. G.; Amaral, R. L.; Santos, Lys Nunes dos; Kruel, Cléber Dario Pinto

doi:10.1111/petr.12104

Cited by 47 publications

(50 citation statements)

References 41 publications

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“…In case of vascular risk (according to surgeon's experience) after initial prophylaxis with enoxaparin during initial hospitalization, at‐risk patients receive aspirin. This policy of LD selection differs obviously between centers: In some series, the rate of LD is 100%, whereas some groups report no living donation; most RTx teams report a 30‐50% proportion of living donation in children below 15 kg …”

Section: Discussionmentioning

confidence: 99%

Renal transplantation in children under 3 years of age: Experience from a single‐center study

Loiseau

Bacchetta

Klich

et al. 2018

Pediatric Transplantation

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RTx remains challenging in children under 3 years of age. This single-center study reviewed the medical records of children <3 years transplanted since 1987 (N = 32, Group 1). They were matched for donor type and RTx period with children aged 3-13 years (N = 32, Group 2) and 13-18 years (N = 32, Group 3). There were no between-group significant differences regarding distributions of gender, primary renal disease, proportion of dialysis before RTx, and growth (SDS). Compared to Groups 2 and 3, Group 1 had more peritoneal dialyses (P < .001), more EBV mismatches (P = .04), and longer warm ischemia times (P < .001). The risk of graft loss was not significantly different among age groups (hazard ratio, 2.4 in Group 2 and 2.0 in Group 3 vs Group 1; P = .2). Death occurred in four patients (3 in Group 1 and 1 in Group 2) and graft loss occurred in 28 patients, mainly due to chronic allograft nephropathy. In recipients <3 years of age, the outcomes of RTx are close to those obtained in older pediatric age groups. Thus, young patients may be transplanted in experienced multidisciplinary teams without additional risks provided that particular attention is paid to donor selection and prevention/early diagnosis of comorbidities and complications.

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Section: Discussionmentioning

confidence: 99%

Renal transplantation in children under 3 years of age: Experience from a single‐center study

Loiseau

Bacchetta

Klich

et al. 2018

Pediatric Transplantation

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“…The greater the size mismatch is, the more proximal recipient vessel anastomoses are used. Still, the available space for an adult-size kidney may present a problem, and to avoid pressure and circulatory problems, it is sometimes safer to close the fascia a few days after the primary operation [30,41]. To ensure urine flow, a transvesical catheter is usually placed in the bladder.…”

Section: Surgerymentioning

confidence: 99%

Renal transplantation in infants

2015

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Renal transplantation (RTx) has become an accepted mode of therapy in infants with severe renal failure. The major indications are structural abnormalities of the urinary tract, congenital nephrotic syndrome, polycystic diseases, and neonatal kidney injury. Assessment of these infants needs expertise and time as well as active treatment before RTx to ensure optimal growth and development, and to avoid complications that could lead to permanent neurological defects. RTx can be performed already in infants weighing around 5 kg, but most operations occur in infants with a weight of 10 kg or more. Perioperative management focuses on adequate perfusion of the allograft and avoidance of thrombotic and other surgical complications. Important long-term issues include rejections, infections, graft function, growth, bone health, metabolic problems, neurocognitive development, adherence to medication, pubertal maturation, and quality of life. The overall outcome of infant RTx has dramatically improved, with long-term patient and graft survivals of over 90 and 80 %, respectively.

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“…There were no differences between the rates for LRDT and DDRT. There were six vascular complications (four vascular thrombosis, one laceration, and one renal artery stenosis) and two perirenal collections [21].…”

Section: Renal Transplantation In Brazilmentioning

confidence: 99%

Alanepe

Koch¹,

Orta²,

Exeni³

2014

Pediatric Nephrology

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It encompasses an extensive territory with many common characteristics and also with significant cultural and socioeconomic differences. Latin America's population is a composite of ancestries and ethnic groups, making the region one of the most diverse in the world. Ethnic composition varies from country to country and includes descendants of Amerindian, European, and African ancestry. Most Latin American countries also have Asian minorities. Europeans and groups with partEuropean heritage make nearly 80 % of the population [1]. In recent years, English-and Frenchspeaking countries are being incorporated in several ways to Latin American activities including medical aspects.Latin America's population is primarily concentrated in urban areas (approximately 80 %), grows at an annual rate of 1.3 %, and as of 2013, was estimated at more than 604 million [1]. In 2012, life expectancy at birth was 77 years; 33 % of the population was 14 years old or younger. By 2020, however, the average age is expected to increase 25 % [2]. The infant mortality rate for the 2009-2013 period is 23/1,000, ranging from 6.2 in Uruguay to 32.8 in Bolivia [3].

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Kidney transplantation in children weighing less than 15 kg: Extraperitoneal surgical access–experience with 62 cases

Cited by 47 publications

References 41 publications

Renal transplantation in children under 3 years of age: Experience from a single‐center study

Renal transplantation in children under 3 years of age: Experience from a single‐center study

Renal transplantation in infants

Alanepe

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