Renal transplantation in pediatric patients with special reference to long‐term cyclosporin treatment in childhood

Publisher Website
Google Scholar
Abstract
Organ grafting in children has to consider chances and degree of rehabilitation over decades. In order to evaluate whether these parameters were improved by the use of cyclosporin (CyA), we analyzed the follow‐ups of 74 children after kidney transplantation. They received 13 living related donor grafts (LD) and 61 cadaveric donor grafts (CD) and were treated with CyA and low‐dose prednisolone. The patient's survival after 1 and 5 years was 100% after LD grafting and 98% after CD grafting. The graft survival rate was also 100% for LD, and 88% after 1 yr and 71% after 5 yr for CD. The mean growth rate was 7 cm/yr in boys and 6 cm/yr in girls for the 1st yr after grafting, but declined to 3 cm/yr and 2.5 cm/yr, respectively, after 5 yr. The rate of hypertension increased during the first 5 yr from 63% to 83%. Graft function estimated as calculated creatinine clearance declined from 50 ml/min/1.73 m2 38 ml/min/1.73 m2. Thus, whilst patients' and graft survival as well as growth rate were improved significantly in CyA treatment, the continuous decrease of graft function over several years points to uncertainty as to the real long‐term outcome.