Renal Transplantation in Pediatric Patients: Surgical Outcomes of 15 Years of Single-Center Experience.

Objectives: Renal transplant is the most appropriate treatment for adult and pediatric patients with end-stage renal failure.

Materials and methods: Fifty-one pediatric kidney transplants were performed in 49 pediatric recipients from a total of 263 kidney recipients at the Gazi University Transplantation Center (Türkiye) between January 2006 and January 2021. We gathered and analyzed data retrospectively from hospital medical records of pediatric transplant recipients.

Results: Kidney grafts were obtained from 18 deceased (35%) and 33 living donors (65%). Among 51 pediatric renal transplants, 10 (19.6%) had complications, with 6 early and 4 late complications. Among 6 early complications posttransplant, 5 were surgical complications (9.8%) and 1 (1.9%) was urologic (1.9%), but no vascular complications were seen. Among 5 surgical complications, 3 (5.8%) were lymphocele and 2 were (3.9%) bleeding complications. Among 4 patients with late complications, 2 had renal artery stenosis and 2 had ureter stenosis. Two patients required re-transplantation because of graft loss from BK virus nephropathy and chronic allograft nephropathy. Among 51 pediatric kidney transplants, 15 recipients (29.4%) presented with 27 cases of infection. Twenty-one acute rejection episodes were seen in 14 of 51 pediatric transplant procedures (27.4%), and 4 humoral rejections occurred in 3 of 51 pediatric transplant procedures (5.8%). In addition, 27 renal transplant patients (52.9%) had normal graft functions at median follow-up of 95 months (98.7 ± 57.7; range, 58-233 mo). Twenty-eight of 51 patients (54.9%) lost kidney grafts over a 15-year follow-up. No graft loss or patient deaths occurred because of surgical complications.

Conclusions: In analysis of 15 years of experience in pediatric renal transplants, our results were within results of other series. Pediatric renal transplant is a safe procedure in our department, based on patient and graft survivals, with no graft loss from surgical complications.