Surgical Complications After Pediatric Renal Transplant

Abstract

Objectives: Renal transplant is the most appropriate treatment for both adult and pediatric patients with end-stage renal failure. Here, we analyzed surgical complications after pediatric renal transplant at our center. Materials and Methods:We retrospectively analyzed data from patient files and hospital charts of pediatric patients who had renal transplant at our center (Gazi University, Ankara, Turkey). Our immunosuppression protocol, a calcineurin inhibitor-based triple regimen, was applied to all recipients (steroids, mycophenolic acid). For neo-ureterocystostomy anastomosis, we used the corner-saving, open-loop continuous suture technique with double J stent for all patients, except when faced with an unfavorable situation. Catheters were removed within 4 weeks after transplant. Results: Among 40 pediatric renal transplant procedures performed at our center since 2006, we had 6 documented surgical complications (15%), with 3 being early and 3 being late complications. In the early transplant period, there were 2 surgical and 1 urologic complications. Eight patients (20%) lost their kidney grafts over the 10-year follow-up. The main reasons for graft loss were chronic allograft nephropathy in 4 patients (10%), BK virus nephropathy in 3 patients (7.5%), and hyperacute rejection in 1 patient (2.5%). Two patients died; however, no patient deaths or graft losses were from surgical complications. Overall graft and patient survival rates were 97% and 100% at 1 year, 94% and 98% at 5 years, and 68% and 95% at 10 years. Conclusions: Renal transplant in pediatric patients is a safe procedure in our department, based on patient and graft survivals, with a low rate of graft loss from surgical problems. As a result, our center is showing success with pediatric renal transplant procedures in accordance with the developed centers in the world.

Outcomes of pediatric deceased donor kidney transplant in northeast Thailand

“…In this study, the majority of KT recipients were male, and the most common etiology of ESRD was congenital anomalies of the kidneys and urinary tract, both of which are consistent with previously published reports 3–10 . However, there were no patients with ESRD caused by obstructive uropathy, which is more common in boys.…”

“…[3][4][5][6][7][8][9][10] However, there were no patients with ESRD caused by obstructive uropathy, which is more common in boys. Peritoneal dialysis was the preferred renal replacement therapy while waiting for a KT because of its advantages in children and the Thai national health security policy.…”

Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation

“…Current approaches show that LG ureterovesical anastomotic technique results in fewer post-operative urological complications (6). The main objective of the centers dealing with solid organ transplantation is to reduce surgical site complications in order to improve the success of transplantation (7). The impact of peritoneal dialysis before kidney transplantation on urinary complications after kidney transplantation is still a matter of debate, and there are many controversies regarding which strategy to use the double J (JJ) stents (8)(9)(10)(11)(12)(13)(14)(15)(16)(17).…”