Renal transplantation is the preferred treatment for renal failure in childhood, but the incidence of graft failure is generally higher than that in adult recipients.
A single center was studied to determine if there were any correctable factors that could contribute to graft failure.
Recipient, donor, and perioperative factors were analyzed using standard statistical tests in 59 pediatric renal transplants performed between 1992 and 1995 using standard cyclosporin-based immunosuppression.
Three factors were found to be significantly different between those recipients with good graft function and those who either died or were returned to dialysis.
Any history of donor hypotension was a detrimental factor (P<. 05, x2 test).
In addition, those with failed grafts were more likely to have received their grafts from younger donors (P=025, Mann Whitney U test).
A third risk factor was a low postoperative central venous pressure in those whose graft ultimately failed (P=0012, Mann Whitney U test).
With a pediatric recipient who is stable and has a low priority for a renal graft, small donors, particularly those who have experienced hypotension, should be considered not suitable for transplantation.
The chances of a successful graft can be improved by good communication between surgeon, pediatrician, and anesthetist.
The importance of maintaining a positive central venous pressure is emphasised.
Mots-clés Pascal : Insuffisance rénale, Traitement, Rejet, Transplantation, Facteur risque, Age, Hypotension artérielle, Donneur, Pression veineuse centrale, Receveur, Etude statistique, Angleterre, Grande Bretagne, Royaume Uni, Europe, Enfant, Homme, Appareil urinaire pathologie, Rein pathologie, Chirurgie
Mots-clés Pascal anglais : Renal failure, Treatment, Rejection, Transplantation, Risk factor, Age, Arterial hypotension, Donor, Central venous pressure, Recipient, Statistical study, England, Great Britain, United Kingdom, Europe, Child, Human, Urinary system disease, Kidney disease, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0535823
Code Inist : 002B14E01. Création : 23/03/1999.