Document Detail

Pre-emptive renal transplantation in children.
MedLine Citation:
PMID:  11328419     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Renal transplantation is a definitive therapeutic modality in end-stage renal disease (ESRD). Most ESRD patients in Japan experience dialysis prior to renal transplantation. The present study was undertaken to examine the usefulness of pre-emptive renal transplantation (PET). METHODS: Between 1987 and 1998, 255 renal transplantations were carried out by the authors. Among those consecutive cases, 10 were cases of PET. In nine pediatric cases, demographics, graft and patient survival, height growth and benefits from successful transplantation were studied and compared with age-matched dialyzed transplantation controls. RESULTS: All transplantation was living-related. There was a disparity of causes of ESRD between the two groups. In PET, acquired renal deterioration due to a congenital lower urinary tract disorder was the major cause. Graft and patient prognosis was favorable in both groups. Growth retardation in PET patients under 15 years of age was significantly less apparent at the time of transplantation and after 3 years compared to the control. The benefits from transplantation were different in the two groups. Most PET patients felt an improvement of their physical condition; however, all of the control patients felt that the major boon was the freedom from the restriction of the daily diet and time for dialysis. CONCLUSION: In pediatric renal transplantation, short-term preceding dialysis does not have a detrimental effect, but PET could benefit ESRD patients by maintaining their quality of life. Moreover, PET minimizes the production of renal dwarfism in prepubertal children. Thus, PET should be taken into consideration in the choice of renal replacement therapy.
H Harada; T Seki; K Nonomura; T Chikaraishi; I Takeuchi; K Morita; T Usuki; Y Watarai; M Togashi; T Hirano; T Koyanagi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of urology : official journal of the Japanese Urological Association     Volume:  8     ISSN:  0919-8172     ISO Abbreviation:  Int. J. Urol.     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-04-30     Completed Date:  2001-11-01     Revised Date:  2006-10-30    
Medline Journal Info:
Nlm Unique ID:  9440237     Medline TA:  Int J Urol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  205-11     Citation Subset:  IM    
Department of Urology, Hokkaido University School of Medicine, Sapporo, Japan.
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MeSH Terms
Acute Disease
Graft Rejection / epidemiology
Kidney Failure, Chronic / surgery*
Kidney Transplantation*
Retrospective Studies

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