A Clinical Analysis of Renal Transplantation in Children / 대한비뇨기과학회지

ABSTRACT

Renal transplantation has been considered the optimal therapeutic modality for children afflicted with end-stage renal disease since the capability became available more than three decades ago to prolong the lives of such children. Nowadays, the outcome of renal transplantation was marked improved, due to the development of immunology and new immunosuppressive agent. But the reports on renal transplantation in children were not many. The Severance Hospital of Yonsei University College of Medicine started the renal transplant program in April, 1979. There were 400 transplants from 1979 to August 1989. Among them, there were 13 cases of child age, and the results were summarized & analyzed. 1. The age incidence of recipients was from 8 to 16. Males were 10 cases and females were 3 Cases. 2. Among the primary diseases of recipients, the congenital diseases were 10 cases and the acquired diseases were 8 cases. And 4 cases were received bilateral nephrectomy due to vesicoureteral reflux and severe proteinuria. 3. Among the donors, 6 cases were related and 7 cases were unrelated. Related donors were 1 haplotype mismatch and unrelated, donors were 2 antigen match including DR locus. 4. There were 6 rejections in 13 cases. Among them, acute rejections were 4 cases and chronic rejections were 2 cases. 5. Postoperative complications were found in 6 cases ; peritoneal rupture, hemoperitoneum, urinary tract infection, smallpox, congestive heart failure and sepsis. 6. Among 13 cases, 11 cases of grafts were survived from 3 months to 9 years. The 1 case was expired due to chronic rejection and respiratory infection after postop. 30 months. And the other 1 case was peritoneal dialyzed due to chronic rejection after postop. 6 months. From the results presented here, we think the outcome of renal transplantation in children is good and the indication should be evaluated carefully.