Paediatric Renal Transplantation — a 15-Year Experience

Mehrotra, S. C.; Gopalakrishnan, Ganesh; Chacko, K.N.; Kekre, Nitin S; Abraham, Bejoy N.; Gnanaraj, Lawrence; Pandey, Abhishek

doi:10.1016/s1015-9584(09)60175-5

Cited by 5 publications

(5 citation statements)

References 24 publications

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“…The mortality rate was 11% (three of 28) and only one death was transplant related. This is comparable with a mortality rate of 0–11% reported at a variety of centers (1–6). The mean duration of allograft function namely 6.3 yr, also compares favorably with what has been observed at pediatric renal transplantation centers.…”

Section: Outcomesupporting

confidence: 84%

“…The causes of ESRD may vary from center to center. For example, in Sweden (1), 79% of patients received a renal transplant because of ESRD due to a congenital cause, while in India (2), the majority had reflux nephropathy. The etiology of ESRD in our patients was generally consistent with reports in the literatures (1, 3–6).…”

Section: Demographymentioning

confidence: 99%

“…Our patients were mainly treated with prednisolone, cyclosporine, azathioprine, mycophenolate mofetil, sirolimus, and tacrolimus similar to the immunosuppressive drugs used at other centers (2, 5, 6). Most centers achieve immunosupression with a minimum of three drugs similar to our finding that 71% of the patients required a combination of three drugs.…”

Section: Outcomementioning

confidence: 99%

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Outcome after renal transplantation in children: Results of follow‐up by nephrologists in a primary referral center

Adedoyin¹,

Frank²,

Vento³

et al. 2003

Pediatric Transplantation

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Pediatric patients who receive a kidney transplant require extended follow-up to monitor graft function and for management of complications. Because of convenience, most patients are sent back to the nephrologists who referred them for transplantation (the primary nephrologist) for long-term care. As a consequence, many pediatric nephrologists who provide this extended care are not associated with a transplant center. It is not known if this arrangement yields satisfactory outcomes for children and adolescents who receive a kidney transplant. The objective was to determine if clinical outcomes are satisfactory in pediatric renal transplant recipients who were followed up by their primary nephrologists after the procedure. A chart review was carried out on all renal transplant recipients seen in the renal clinic at Schneider Children's Hospital (SCH) from 1982 to 2001. Patients were eligible if they were followed up by the primary referring nephrologists at SCH for a minimum of 6 months after transplantation. Relevant demographic and clinical outcome data were compiled. Twenty-eight patients who received a total of 33 renal allografts [living related donors (LRD) 15 and cadaveric donors (CD) 18] were seen during the study period. The transplantations in 19 children (68%) were carried out at Montefiore Hospital (Bronx, NY, USA), while the rest were performed at other centers. There were three (11%) deaths, two LRD patients and one CD patient. The group of 25 surviving patients consisted of 17 males and eight females, age range 4-28 yr (mean 17.2 yr). The mean duration of renal allograft survival was 6.3 +/- 5.3 yr and the mean duration of follow-up was 6.1 +/- 5.3 yr. The most recent serum creatinine ranged from 0.5 to 3.8 mg/dL with a mean of 1.3 +/- 0.8 mg/dL. There were several complications including acute rejection, renal artery stenosis, and hydronephrosis in the allograft. The team of primary referring nephrologists successfully treated all of these except the child with hydronephrosis. The primary nephrologist who refers pediatric patients to a tertiary care transplant center can accomplish long-term follow-up of renal transplant recipients after discharge from the transplant center. The clinical outcomes are acceptable and compare favorably with the results described in the literature that have been achieved in patients followed up at transplant centers. Problems rarely developed that required referral back to the transplant center for management. This approach to care is recommended because it is more likely to foster compliance by both patients and parents.

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Section: Outcomesupporting

confidence: 84%

Section: Demographymentioning

confidence: 99%

Section: Outcomementioning

confidence: 99%

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Outcome after renal transplantation in children: Results of follow‐up by nephrologists in a primary referral center

Adedoyin¹,

Frank²,

Vento³

et al. 2003

Pediatric Transplantation

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“…In the absence of a transplant registry or a cadaver transplant program, children are most likely to receive a kidney from a live related donor, more often the mother. Graft survival ranges from 73%-88% at one year and 71%-86% at three years [21][22][23].…”

Section: Renal Replacement Therapymentioning

confidence: 99%

Chronic Kidney Disease in Children: An Indian Perspective

Kanitkar¹

2009

Medical Journal Armed Forces India

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“…The paediatric renal transplant experience from India depicts that the graft survival ranges from 73 to 88% at 1 year and 71 to 86% at 3 years. [ 8 9 10 11 ] Haemodialysis and PD remain the bridge to renal transplant and the wait is often unending for want of financial support.…”

Section: Introductionmentioning

confidence: 99%

Chronic peritoneal dialysis in children with chronic kidney disease

Sharawat

Tiewsoh

Soni

et al. 2021

Journal of Family Medicine and Primary Care

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Introduction: Chronic peritoneal dialysis (CPD) is an important modality of renal replacement therapy (RRT) in children of all ages with end-stage renal disease (ESRD). We retrospectively assessed the clinical profile of children with chronic kidney disease (CKD) initiated on CPD at a tertiary care centre in Northern India. Materials and Methods: Retrospective data of 13 children with CKD and initiated on CPD between 2016 and 2019 were retrieved and analysed. The demographic and clinical profile, aetiology of CKD, method of catheter insertion, mode of dialysis, complications, and catheter survival rate were analysed. Results: The median age at the onset of the symptoms was 81 months interquartile range (IQR 11–90) and the median age at the diagnosis was 81 months (IQR 36–103). The median age at the initiation of CPD was 92.97 months (IQR 74.43–108.79). The median serum creatinine at the initiation of CPD was 6.3 mg/dL (IQR 4.25–8.4). During a total study period of 84 CPD months, we observed 16 catheter-related complications and a complication rate of 1 per 5.25 CPD months. The overall peritonitis rate was 1 episode per 13.66 patient-months (0.87 episodes per patient-year). The catheter displacement/migration was seen in 23% of the cases. The median duration of follow-up was 175 days (IQR 85–249) with the longest follow-up duration of 502 days. Conclusion: CPD is the modality of choice for smaller children with ESRD as venous access is difficult to achieve in smaller children. Complications especially related to infections are a major concern in addition to poor growth associated with ESRD.

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Paediatric Renal Transplantation — a 15-Year Experience

Cited by 5 publications

References 24 publications

Outcome after renal transplantation in children: Results of follow‐up by nephrologists in a primary referral center

Outcome after renal transplantation in children: Results of follow‐up by nephrologists in a primary referral center

Chronic Kidney Disease in Children: An Indian Perspective

Chronic peritoneal dialysis in children with chronic kidney disease

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