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Pediatr Transplant ; 19(8): 836-43, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26329665

RESUMO

Kidney transplantation is the optimal treatment of ESRD in children. Some studies have reported inferior outcomes in recipients of LDN allografts who are ≤ 5 yr of age. We performed a retrospective review of pediatric recipient outcomes of 110 LDN allografts at our institution and examined predictors of adverse outcomes. Subgroup analysis was performed by dividing recipients into three age categories: 0-5 yr, 6-17 yr, and ≥ 18 yr. There was no significant difference between incidences of DGF or ARE between groups. Kaplan-Meier analysis demonstrated 100% allograft survival in 0- to 5-yr-old recipients, nearly reaching statistical significance (p = 0.07) for outcome superior to that of the two older age groups. Pretransplant HD was associated with increased risk of DGF (p = 0.05). Significant risk factors for ARE were recipient weight >15 kg (p = 0.033) and multiple renal arteries (p = 0.047). Previous ARE was associated with an increased risk of allograft failure (p = 0.02). LDN is not associated with increased risk of DGF, ARE, or allograft failure in the youngest recipients. These findings support an aggressive pursuit of preemptive transplantation even in the youngest pediatric allograft recipients.


Assuntos
Falência Renal Crônica/cirurgia , Transplante de Rim , Laparoscopia , Doadores Vivos , Nefrectomia/métodos , Coleta de Tecidos e Órgãos/métodos , Adolescente , Fatores Etários , Criança , Pré-Escolar , Função Retardada do Enxerto/etiologia , Feminino , Seguimentos , Rejeição de Enxerto/etiologia , Sobrevivência de Enxerto , Humanos , Lactente , Recém-Nascido , Estimativa de Kaplan-Meier , Masculino , Estudos Retrospectivos , Fatores de Risco , Transplante Homólogo , Resultado do Tratamento , Adulto Jovem
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