Document Detail


The outcome of renal transplantation in children without prolonged pre-transplant dialysis.
MedLine Citation:
PMID:  2009719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Controversy in the literature exists over whether or not it is beneficial to maintain a patient on dialysis for a prolonged time before transplantation. Because no data exist comparing children who have had prolonged dialysis before transplantation to those who have none, we reviewed the charts of all children transplanted at the Children's Hospital of the Cleveland Clinic Foundation. Of those, we selected three groups for analysis: group one (n = 12) consisted of patients who had had less than or equal to 10 weeks of dialysis before transplantation (6.8 +/- -2.2 weeks, +/- = SD); group two (n = 21) were patients who had had more than 10 weeks of dialysis (142 + +/- -148 weeks). Both groups had two years of follow-up data. Group three (n = 13) consisted of patients who had had less than two years of follow-up (18.7 +/-/-7 months) but no dialysis before transplantation. There were no differences in mode of dialysis between groups one and two nor in the type of transplant (living-related donor vs. cadaveric). Significantly, the patients in group three received more cyclosporine A and less anti-lymphocyte globulin than the other two groups (p less than 0.05). Patients in group two received more transfusions (11.9 +/- 14.3) than patients in group one (4.0 +/- 2.7) and group three (3.5 +/- 7.3). There were no differences in number of patients who experienced at least one rejection episode among the three groups. Although the mean serum creatinine concentration at two years of follow-up was higher in group two (3.6 +/- -3.9 mg/dl), this was not significantly different from group one (1.7 +/- -0.7 mg/dl) or group three (1.9 +/- -0.5, n = 7). Sixty-three percent of patients in group one, 60% of patients in group two and 91% in group three had functioning allografts at two years follow-up. Although there may be other considerations, our data do not indicate any increase in rejection or decrease in graft survival in children who do not receive prolonged dialysis.
Authors:
D S Fitzwater; B H Brouhard; D Garred; R J Cunningham; A C Novick; D Steinmuller
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical pediatrics     Volume:  30     ISSN:  0009-9228     ISO Abbreviation:  Clin Pediatr (Phila)     Publication Date:  1991 Mar 
Date Detail:
Created Date:  1991-05-03     Completed Date:  1991-05-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372606     Medline TA:  Clin Pediatr (Phila)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  148-52     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, Children's Hospital, Cleveland, OH.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antilymphocyte Serum
Azathioprine / therapeutic use
Blood Transfusion / statistics & numerical data
Child
Child, Preschool
Creatinine / blood
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Kidney Transplantation / physiology,  statistics & numerical data*
Male
Ohio / epidemiology
Peritoneal Dialysis, Continuous Ambulatory / statistics & numerical data
Prednisone / therapeutic use
Prognosis
Renal Dialysis / statistics & numerical data*
Time Factors
Chemical
Reg. No./Substance:
0/Antilymphocyte Serum; 446-86-6/Azathioprine; 53-03-2/Prednisone; 60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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