RESULTS OF KIDNEY TRANSPLANTATION IN THE YOUNG CHILD
| Autor: | Thomas A. Polta, David S. Fryd, John S. Najarian, Caliann T. Lum |
|---|---|
| Rok vydání: | 1982 |
| Předmět: |
Adult
Male Nephrology medicine.medical_specialty Adolescent Urology medicine.medical_treatment Splenectomy Renal Artery Obstruction Renal artery stenosis Sepsis Postoperative Complications Internal medicine medicine Humans Transplantation Homologous Child Kidney transplantation Sex Characteristics Transplantation Kidney business.industry Graft Survival Hemodynamics Infant Newborn Central venous pressure Infant Immunosuppression Kidney Tubular Necrosis Acute Middle Aged medicine.disease Kidney Transplantation Surgery medicine.anatomical_structure Child Preschool Female business Ureteral Obstruction |
| Zdroj: | Transplantation. 34:167-171 |
| ISSN: | 0041-1337 |
| DOI: | 10.1097/00007890-198210000-00002 |
| Popis: | One hundred and two consecutive first kidney transplants were performed in children 10 years old and younger (47 ≤ 5 years old) at the University of Minnesota between June 1963 and April 1981. Five infants under 1-year old received transplants, two of whom are alive and well. The mean age was 6 years and mean weight was 16 kg. The most common primary renal diseases were congenital hypoplastic-dysplastic kidneys (25.5%), congenital nephrosis (20%), and glomerulonephritis (16.5%). Statistical analyses of cumulative patient and graft survival were based on the results of 88 first kidney transplants performed in children 1 to 10 years old since 1968 when medical management, patient selection criteria, surgical technique, and immunosuppression protocols were standardized. Patient survival was 72%. Twenty-six percent received transplants at least twice (23 of 88), one-half of whom still have functioning second grafts. Mean intraoperative systolic blood pressures were significantly lower in children who received intraperitoneal versus extraperitoneal grafts. No differences in central venous pressure were observed. The mean blood pressure drop at the time of revascularizing the kidney did not appear to be directly related to the incidence of postoperative acute tubular necrosis (ATN). Most patients underwent splenectomy prior to or at the time of transplantation. With the use of prophylactic antibiotics, splenectomy was not a single determining factor in deaths from sepsis. Technical complications were few (four renal artery stenosis and six ureteral revisions). Results of parent to child kidney transplants in the child under 10 did not differ significantly from those results seen in an older (17 to 49) parent to child group who received transplants at this same center. |
| Databáze: | OpenAIRE |
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