Surgical Complications After Pediatric Renal Transplant


Sozen H., Fidan K., Ozen O., Soylemezoglu O., DALGIÇ A.

EXPERIMENTAL AND CLINICAL TRANSPLANTATION, no.3, pp.344-347, 2019 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2019
  • Doi Number: 10.6002/ect.2016.0061
  • Journal Name: EXPERIMENTAL AND CLINICAL TRANSPLANTATION
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.344-347
  • Keywords: Outcome, Pediatric renal transplantation, UROLOGIC COMPLICATIONS, ARTERY STENOSIS
  • Gazi University Affiliated: Yes

Abstract

Objectives: Renal transplant is the most appropriate treatment for both adult and pediatric patients with end-stage renal failure. Here, we analyzed surgical complications after pediatric renal transplant at our center. Materials and Methods: We retrospectively analyzed data from patient files and hospital charts of pediatric patients who had renal transplant at our center (Gazi University, Ankara, Turkey). Our immunosuppression protocol, a calcineurin inhibitor-based triple regimen, was applied to all recipients (steroids, mycophenolic acid). For neo-ureterocystostomy anastomosis, we used the corner-saving, open-loop continuous suture technique with double J stent for all patients, except when faced with an unfavorable situation. Catheters were removed within 4 weeks after transplant. Results: Among 40 pediatric renal transplant procedures performed at our center since 2006, we had 6 documented surgical complications (15%), with 3 being early and 3 being late complications. In the early transplant period, there were 2 surgical and 1 urologic complications. Eight patients (20%) lost their kidney grafts over the 10-year follow-up.The main reasons for graft loss were chronic allograft nephropathy in 4 patients (10%), BK virus nephropathy in 3 patients (7.5%), and hyperacute rejection in 1 patient (2.5%). Two patients died; however, no patient deaths or graft losses were from surgical complications. Overall graft and patient survival rates were 97% and 100% at 1 year, 94% and 98% at 5 years, and 68% and 95% at 10 years. Conclusions: Renal transplant in pediatric patients is a safe procedure in our department, based on patient and graft survivals, with a low rate of graft loss from surgical problems. As a result, our center is showing success with pediatric renal transplant procedures in accordance with the developed centers in the world.