Renal Transplantation in Children Younger Than 6 Years Old

Garcia, Clotilde Druck; Bittencourt, V.; Pires, F.; Didoné, Eduardo Chaise; Guerra, Enilde Eloena; Vitola, Santo Pascual; Antonello, Jerônimo Sperb; Malheiros, Danielle; Tumelero, A.; Garcı́a, Valter Duro

doi:10.1016/j.transproceed.2007.01.006

Cited by 11 publications

(12 citation statements)

References 19 publications

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“…Ganger et al reported that RTx in children weighing <15 kg was not associated with increased risk of surgical complications . In our cohort, four children in G1 (ie, 12.5% of the youngest group) had arterial or venous thromboses, which is similar to reports by Dall'Amico et al in 2001 (n = 4/39) or Garcia et al in 2007 (n = 4/38) . The incidence of other surgical complications was also similar to previously published data.…”

Section: Discussionsupporting

confidence: 92%

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: Discussionsupporting

confidence: 92%

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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“…In the early years of renal transplantation, the results were lower in young children compared with older children or adults, but in recent years its practice has substantially improved outcomes for children with NSFL to be similar to those obtained in patients with different renal diseases who require transplants [2,14e16]. In the present study, after a mean follow-up time of 6 years (range, 1 month to 16.9 years) from first transplantation, we found an actuarial survival at both 1 and 7 years of 92.9%, which is similar to that observed in others series [17,18]. No case presented recurrence of NS, as observed in previous studies reporting low or no recurrence [9,19].…”

Section: Discussionsupporting

confidence: 90%

Renal Transplantation in Children With Nephrotic Syndrome in the First Year of Life

Mejía¹,

Melgar²,

Hijosa³

et al. 2015

Transplantation Proceedings

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“…In both reports, some of the success is attributed to a very aggressive fluid management, and they underscore the critical importance of appropriate fluid resuscitative measures in small recipients of adult-sized kidneys [47]. A minimum recipient weight of 5, preferable 10 kg is suggested prior to operation [36]. The operative technique is based on the weight and not the age of the child.…”

Section: Recipient Risk Factors For Development Of Vascular Thrombmentioning

confidence: 99%

Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature

Keller

Jørgensen

Jespersen

2012

Journal of Transplantation

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Renal graft survival has improved over the past years, mainly owing to better immunosuppression. Vascular thrombosis, though rare, therefore accounts for up to one third of early graft loss. We assess current literature on transplantation, identify thrombosis risk factors, and discuss means of avoiding thrombotic events and saving thrombosed grafts. The incidence of arterial thrombosis was reported to 0.2–7.5% and venous thrombosis 0.1–8.2%, with the highest incidence among children and infants, and the lowest in living donor reports. The most significant risk factors for developing thrombosis were donor-age below 6 or above 60 years, or recipient-age below 5-6 years, per- or postoperative hemodynamic instability, peritoneal dialysis, diabetic nephropathy, a history of thrombosis, deceased donor, or >24 hours cold ischemia. Multiple arteries were not a risk factor, and a right kidney graft was most often reported not to be. Given the thrombosed kidney graft is diagnosed in time, salvage is possible by urgent reoperation and thrombectomy. Despite meticulous attentions to reduce thrombotic risk factors, thrombosis cannot be entirely prevented and means to an early detection of this complication is desirable in order to save the kidneys through prompt reoperation. Microdialysis may be a new tool for this.

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Renal Transplantation in Children Younger Than 6 Years Old

Cited by 11 publications

References 19 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 Children With Nephrotic Syndrome in the First Year of Life

Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature

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