LONG - TERM RESULTS OF PEDIATRIC KIDNEY TRANSPLANTATION AT THE UNIVERSITY OF HEIDELBERG: A 35 YEAR SINGLE - CENTRE EXPERIENCE

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MEHRABI A.; SCHEMMER P.; KRAUS T.; WIESEL M.; BIICHLER M.W.; SCHMIDT J.; KASHFI A.; TONSHOFF B.; FENEBERG R.; MEHLS O.

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Journal: Iranian Journal of Surgery Year:2005 | Volume:13 | Issue:34 Page(s): 18-26

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Title

LONG - TERM RESULTS OF PEDIATRIC KIDNEY TRANSPLANTATION AT THE UNIVERSITY OF HEIDELBERG: A 35 YEAR SINGLE - CENTRE EXPERIENCE

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Keywords

CADAVERIC DONORQ4

COLD ISCHEMIA TIMEQ4

IMMUNOSUPPRESSIONQ4

LIVING DONORQ4

PEDIATRIC KIDNEY TRANSPLANTATIONQ4

SURGICAL TECHNIQUEQ4

SURVIVAL RATEQ4

Abstract

Introduction & Objective: Kidney transplantation remains the most effective treatment for children with end-stage renal disease. We analyzed data from the University of Heidelberg transplant programme to present our results on PEDIATRIC KIDNEY TRANSPLANTATIONs over the past 35 years.Material & Methods: From 1967 to 2003, 354 PEDIATRIC KIDNEY TRANSPLANTATIONs were performed at the University of Heidelberg. Data were obtained from the PEDIATRIC KIDNEY TRANSPLANTATION records consisting of 291 (82%) cadaver and 63 (18%) living donated transplants. Demographic data, familial relationship of the LIVING DONORs, SURGICAL TECHNIQUE, immunosuppressive drugs, graft and patient SURVIVAL RATEs were assessed.Results: The mean age of cadaveric and LIVING DONORs was 32.0±17.1 and 37.6±7.5 years, respectively.The familial relationship of the LIVING DONORs included the mother in 65% of cases, the father in 31%, and other relatives in 4%. In the last 4 years, the respective mean COLD ISCHEMIA TIME was 1.6±0.5h for living donated and 13.5±4.1h for CADAVERIC DONORs. The mean age of children who received kidneys from cadaveric and LIVING DONORs was 11.3±4.5 and 10.4±4.5 years, respectively, with a male to female ratio of 57 to 43%. Overall patient SURVIVAL RATEs were 95% after 1 year and 89% after 5 years. The patient 5 and 10 year SURVIVAL RATEs for LIVING DONOR renal transplantations were 95 and 95%, respectively. Graft SURVIVAL RATEs improved since 1990 compared with the period prior to1990: 82.5 vs 56.7% graft survival at 1 year and 82.5 vs 50% after 5 years (P=0.03). Comparing the operating technique in a subgroup of our patients that received the same immunosuppressive regimen, anastomoses with the aorta and vena cava (51%, n=31) were associated with a graft survival of 86.6 and 83.3% after 1 and 5 years, whereas anastomoses with iliac vessels (49%, n=30) were associated with a graft survival of 55.8 and 51.6% after 1 and 5 years, respectively (P=0.01).Conclusions: There has been a gradual improvement in our paediatric kidney transplantation results over time. LIVING DONOR paediatric kidney transplants have higher patient and better graft SURVIVAL RATEs than CADAVERIC DONOR kidney transplants. Using the aorta and inferior vena cava for graft anastomosis, utilizing newer immunosuppressive drugs and implementing living kidney donation have positively affected the results of our PEDIATRIC KIDNEY TRANSPLANTATIONs.

Cites

IDENTIFY SURVIVAL PREDICTORS OF THE FIRST KIDNEY TRANSPLANTATION: A RETROSPECTIVE COHORT STUDY

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APA: Copy

MEHRABI, A., SCHEMMER, P., KRAUS, T., WIESEL, M., BIICHLER, M.W., SCHMIDT, J., KASHFI, A., TONSHOFF, B., FENEBERG, R., & MEHLS, O.. (2005). LONG - TERM RESULTS OF PEDIATRIC KIDNEY TRANSPLANTATION AT THE UNIVERSITY OF HEIDELBERG: A 35 YEAR SINGLE - CENTRE EXPERIENCE. IRANIAN JOURNAL OF SURGERY, 13(34), 18-26. SID. https://sid.ir/paper/112787/en

Vancouver: Copy

MEHRABI A., SCHEMMER P., KRAUS T., WIESEL M., BIICHLER M.W., SCHMIDT J., KASHFI A., TONSHOFF B., FENEBERG R., MEHLS O.. LONG - TERM RESULTS OF PEDIATRIC KIDNEY TRANSPLANTATION AT THE UNIVERSITY OF HEIDELBERG: A 35 YEAR SINGLE - CENTRE EXPERIENCE. IRANIAN JOURNAL OF SURGERY[Internet]. 2005;13(34):18-26. Available from: https://sid.ir/paper/112787/en

IEEE: Copy

A. MEHRABI, P. SCHEMMER, T. KRAUS, M. WIESEL, M.W. BIICHLER, J. SCHMIDT, A. KASHFI, B. TONSHOFF, R. FENEBERG, and O. MEHLS, “LONG - TERM RESULTS OF PEDIATRIC KIDNEY TRANSPLANTATION AT THE UNIVERSITY OF HEIDELBERG: A 35 YEAR SINGLE - CENTRE EXPERIENCE,” IRANIAN JOURNAL OF SURGERY, vol. 13, no. 34, pp. 18–26, 2005, [Online]. Available: https://sid.ir/paper/112787/en

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