Niertransplantaatoverleving en chirurgische complicaties bij kinderniertransplantaties; ervaringen in het Emma Kinderziekenhuis AMC

To describe surgical complications, and patient and kidney transplant survival rates in children who have had a kidney transplant.

Design

Retrospective.

Method

Data were analysed concerning the children who had been treated with a renal transplantation in the period 1985-2001 because of terminal renal insufficiency in the Emma Children’s Hospital of the Academic Medical Centre in Amsterdam, the Netherlands, with arbitrary end date October 7, 2002.

Results

In the study period, 55 primary kidney transplantations were performed on 24 girls and 31 boys. 13 living related and 42 post mortem transplantations were performed. The extra-peritoneal approach was performed in all recipients. Up to October 7, 2002, 14 surgical complications (25) developed: 4 cases of renovascular thrombosis, 4 urinary leakages, 6 urethral strictures, 1 urethral necrosis, 5 haematomas and 3 lymphoceles. 6 patients lost their grafts due to surgical complications (11); 4 due to thrombosis, 1 due to urethral necrosis and 1 due to haemorrhage or haematoma. Due to hypertension secondary to the underlying kidney disease 2 patients died within one year after transplantation from hypertensive encephalopathy and cerebral bleeding respectively. The one- and five-year graft survival was 83 and 74 for living related transplantations respectively, and for post mortem transplantations 78 and 68 respectively. The main causes of graft loss were chronic rejection (9/21; 43), acute rejection (4/21; 19), thrombosis (4/21; 19) and surgical complications (2/21; 10). Primary non-function was the only factor with a negative prognostic value for graft survival.

Ned Tijdschr Geneeskd 2005;149:584-8