Our ınitial experiences and outcomes of pediatric kidney transplantations

Abstract

Abstract Objectives: Kidney transplantation is the best treatment method associated with improved quality of life and better survival for both adult and pediatric patients with end stage renal disease. We have performed a total of 117 kidney transplantations from living or deceased donors between November 2010 and May 2014. Thirteen of these were pediatric kidney transplantations. Here, we present our initial experiences and outcomes of these pediatric kidney transplantations. Materials and Methods: One of the pediatric recipients who underwent en bloc and dualkidney transplantation from a deceased donor was excluded from this study. This recipient was a 40-month-old patient whose donor was an eleven-month-infant. Her allograft kidneys were explanted because of vascular thrombosis on the first postoperative day. We collected and retrospectively analyzed the data of the other twelve pediatric transplantation recipients and their donors. Seven of these kidney transplantations were from deceased donors and five from living donors. All recipients and the five living donors underwent a thorough examination and their clinical history was studied with in detail. Results: Deceased to living donor ratio was 7:5, respectively. The mean follow up period was 31.8 (1-42) months from living donors group and 16.8 (2-28) months from deceased donors group, respectively. Graft survival was 100% during this period. No kidney was lost from rejection, technical causes, infection or recurrent diseases. The living donors are also still alive without any problems. Conclusion: For pediatric end stage renal disease patients, kidney transplantation should be done from deceased or living donors as soon as possible. Keywords: Pediatric; Kidney; Transplantation.

Öz Amaç: Hem çocuk hem de erişkin böbrek yetmezliği hastaları için en iyi tedavi seçeneği yaşam süresini ve kalitesini de artıran böbrek naklidir. Kasım 2010 ile Mayıs 2014 tarihleri arasında toplam 117 hastaya böbrek nakli yaptık bunların 13’ü çocuk hastalardı. Çocuk hastalara yaptığımız böbrek nakilleri ile ilgili ilk deneyimlerimizi ve sonuçlarımızı burada sunmayı amaçladık. Materyal ve Metot: En bloc ve dual böbrek nakli yaptığımız bir olgumuz bu çalışmanın dışında bırakıldı. Geriye kalan 12 hasta ve donörlerinin kayıtları geriye doğru toplanarak incelendi. Bulgular: Hastalarımızın 7’sine kadavradan, 5’ine canlı donörlerinden nakil yaptık. Canlı donörden nakil yaptığımız alıcıların ortalama takip süreleri 31.8 ay(dağılım; 1-42 ay), kadaverik donörden nakil yaptığımız alıcıların ise16.8 aydı (dağılım; 2-28 ay). Takip süresince greft sağkalım oranı %100’dü. Teknik nedenlerden, altta yatan hastalıkların tekrar etmesi, infeksiyon ya da rejeksiyon nedeni ile organ kaybetmedik. Sonuç: Çocuk yaş grubundaki kronik böbrek yetmezliği olan hastlara kadaverik ya da canlı donörden olabildikçe erken böbrek nakili yapılmalıdır. Çocuklara; hem kadavradan hemde canlıdan nakiller nakil merkezi yeni kurulmuş olsada güvenli bir şekilde yapılabilinir. Anahtar Kelimeler: Çocuk; Böbrek; Nakil.