The first 10 years of the dialysis-transplantation program at The Hospital for Sick Children, Toronto. 2. Transplantation and complications of chronic renal failure.

Between January 1969 and August 1977, 78 children received 100 kidney transplants (94 from cadavers and 6 from living donors) at The Hospital for Sick Children, Toronto. Since 1971 the average wait for a first cadaveric transplant has been less than 5 months. Preferably the kidney is placed in a location that has not previously undergone an operation, usually the iliac fossa on the side opposite that from which the donor kidney was taken. Immunosuppressive therapy begins with prednisone (or methylprednisolone), 3 mg/kg body weight per day; the dose is gradually decreased until a maintenance dose of 10 to 20 mg every 48 hours is reached 3 to 6 months postoperatively. Azathioprine, 2 to 3 mg/kg body weight, is also given each day. Early recognition or prevention of renal osteodystrophy, the toxic effects of steroids, psychosocial problems, growth retardation and hypertension minimize their effects on these patients.