Pre-emptive renal transplantation in children and adolescents*

Abstract

Forty-three out of 204 children received their first renal transplant without prior dialysis. In order to evaluate the outcome of pre-emptive transplantation, two groups were compared retrospectively. The groups consisted of 28 children who received their transplants either without prior dialysis (ND) or after a varying period of dialysis (D). They were matched by age, year of transplantation, immunosuppressive regimen, donor source, and original disease. The percentage of living related donors was 50% in each group. Patient survival was identical in both groups; one patient died in each group due to infection in the early post-transplantation period. The 5-year graft survival rates were 89% in the ND group versus 72% in the D group. The functional parameters graft function, anemia, hyperparathyroidism, hypertension, and the growth rates tended to be slightly better in the ND group than in the D group. The differences, however, were not significant. We conclude that pre-emptive transplantation is a safe procedure that shortens the period of uremia and is, therefore, recommended for children with end-stage renal failure.

Pediatric live-donor kidney transplantation in Mansoura Urology & Nephrology Center: a 28-year perspective

“…Mahmoud et al reported a higher incidence of graft thrombosis in pre-emptive transplantations [11]. However, favorable results, similar to ours, were reported by other authors [12][13][14]. In addition to this favorable graft survival, transplantation before the need for dialysis has a number of other potential advantages.…”