Cadaveric kidney transplantation in children < or =20 kg in weight: long-term single-center experience.

BACKGROUND

We report long-term follow-up data on cadaveric kidney transplantation in children < or =20 kg in weight.

METHODS

Between January 1990 and October 2003, we performed 19 cadaveric renal transplants in 19 children < or =20 kg in weight. Mean age at transplantation was 4.7 years (range 18 months to 9 years). Mean weight at transplantation was 14.4 kg (range 9 to 20 kg). Nine patients had preemptive kidney transplantation, whereas 10 were maintained on renal replacement therapy before the transplant operation.

RESULTS

Actuarial 1-, 3-, 5-, and 10-year patient survival rates were 89.5%, 89.5%, 89.5%, and 82%, respectively. Actuarial 1-, 3-, 5-, and 10-year graft survival rates were 79%, 73%, 73%, 65%, respectively. Three patients died. Eight grafts failed. Cause of graft failure was death with a functioning graft in 3 patients, chronic rejection in 1, acute cellular rejection in 1, vascular rejection in 1, hemolytic-uremic syndrome in 1, and unknown in 1.

CONCLUSIONS

Our results indicate the success of cadaveric kidney transplantation in the very small child with results comparable to living related donor transplantation.