Pediatric renal transplantation: 5 years experience from Jaslok Hospital, Mumbai

ObjectivesTo evaluate the patient characteristics, complications and outcome of renal transplantation in pediatric end stage renal disease (ESRD).Type of studyRetrospective observational analysis.SubjectsChildren with ESRD subjected to renal transplantation in last 5 years (April 2007–March 2012) at Jaslok Hospital.MethodsDemographic data of the transplant recipients and donors, prior dialysis, surgical details of renal transplantation, immunosuppression, medical and surgical complications and post-transplant follow up and outcome was assessed.Results20 children in the age group 6–18 years (mean 14.6 years) underwent renal transplantation in last 5 years at our hospital. Fifteen percent cases (n = 3) weighed < 20 kg at transplantation. Primary cause of renal failure was glomerular in 30%, tubulo-interstitial in 45% and unknown in 25%. All were primary transplants, pre-emptive in 15%; live related in 95%, cadaveric in 5%. Mothers were the kidney donors in 60% cases. Induction therapy was used in 60% while maintenance therapy comprised of triple regimen. UTI was the commonest surgical complication (40%) followed by perinephric collection (20%), lymphocoele (15%) and renovascular thrombosis (10%, associated with graft dysfunction). 15% cases experienced graft rejection (acute cellular rejection (ACR), 66.6% and antibody mediated rejection (AMR), 33.3%) with complete renal recovery following treatment.73.4% and 72.8% cases had functioning grafts at the end of one and three years respectively.ConclusionsPediatric renal transplantation was associated with 100% patient survival and is a safe therapeutic option for children with ESRD.