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Transplantation of infant en bloc kidneys into paediatric recipients

Laube, Guido ; Kellenberger, Christian ; Kemper, Markus ; Weber, Markus ; Neuhaus, Thomas

In: Pediatric Nephrology, 2006, vol. 21, no. 3, p. 408-412

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    Titre
    • Transplantation of infant en bloc kidneys into paediatric recipients
    Auteur
    • Laube, Guido. Department of Paediatric Nephrology, University Children's Hospital, Steinwiesstrasse75, 8032, Zurich, Switzerland
    • Kellenberger, Christian. Department of Diagnostic Imaging, University Children's Hospital, Zurich, Switzerland
    • Kemper, Markus. Department of Paediatric Nephrology, University Children's Hospital, Steinwiesstrasse75, 8032, Zurich, Switzerland
    • Weber, Markus. Department of Visceral Surgery, University Hospital, Zurich, Switzerland
    • Neuhaus, Thomas. Department of Paediatric Nephrology, University Children's Hospital, Steinwiesstrasse75, 8032, Zurich, Switzerland
    Type de document
    • Postprint
    Identifiant OAI-PMH
    • oai:doc.rero.ch:313425
    Summary
    En bloc renal transplantation (EBT) from infant donors is an option for children with end-stage renal failure. Owing to potential complications, EBT is not performed in all paediatric nephrology centres. We evaluated the perioperative and long-term course of five children undergoing EBT. Primary diagnosis was atypical (diarrhoea-negative) haemolytic uraemic syndrome (n=2), interstitial nephropathy (two siblings) and branchio-oto-renal syndrome (n=1). Recipient and donor ages ranged between 5.9 and 11.1 years and 0.3 and 2.5 years, respectively. Follow-up time after EBT was 2.1-13.2 years. Perioperative complications included (1) a renal artery thrombosis, with immediate intraoperative reconstruction and primary non-functioning of the graft, with recovery after 10 days, and (2) a vesico-ureteric obstruction, successfully managed with temporary insertion of a JJ-catheter. All grafts had good long-term function. Absolute glomerular filtration rate (GFR; millilitres/minute) increased in all patients, whereas relative GFR (millilitres/minute per 1.73m2 body surface area) remained stable during the follow-up period in all but one. Kidney size increased significantly, with maximal growth during the first year after EBT; magnetic resonance imaging (MRI) showed normal structure and vasculature. EBT is a safe and effective option for young children with end-stage renal failure. Absolute GFR and graft size increase and adapt to the children's growing body mass