Basiliximab induced non-cardiogenic pulmonary edema in two pediatric renal transplant recipients.

Hdl Handle:
http://hdl.handle.net/10147/263318
Title:
Basiliximab induced non-cardiogenic pulmonary edema in two pediatric renal transplant recipients.
Authors:
Dolan, Niamh; Waldron, Mary; O'Connell, Marie; Eustace, Nick; Carson, Kevin; Awan, Atif
Affiliation:
Department of Nephrology, Children's University Hospital, Dublin, Ireland. dolanniamh@eircom.net
Citation:
Basiliximab induced non-cardiogenic pulmonary edema in two pediatric renal transplant recipients. 2009, 24 (11):2261-5 Pediatr. Nephrol.
Journal:
Pediatric nephrology (Berlin, Germany)
Issue Date:
Nov-2009
URI:
http://hdl.handle.net/10147/263318
DOI:
10.1007/s00467-009-1244-4
PubMed ID:
19649661
Abstract:
We report two cases of non-cardiogenic pulmonary edema as a complication of basiliximab induction therapy in young pediatric renal transplant patients identified following a retrospective review of all pediatric renal transplant cases performed in the National Paediatric Transplant Centre, Childrens University Hospital, Temple Street, Dublin, Ireland. Twenty-eight renal transplantations, of which five were living-related (LRD) and 23 were from deceased donors (DD), were performed in 28 children between 2003 and 2006. In six cases, transplantations were pre-emptive. Immunosuppression was induced pre-operatively using a combination of basiliximab, tacrolimus and methylprednisolone in all patients. Basiliximab induction was initiated 2 h prior to surgery in all cases and, in 26 patients, basiliximab was re-administered on post-operative day 4. Two patients, one LRD and one DD, aged 6 and 11 years, respectively, developed acute non-cardiogenic pulmonary edema within 36 h of surgery. Renal dysplasia was identified as the primary etiological factor for renal failure in both cases. Both children required assisted ventilation for between 4 and 6 days. While both grafts had primary function, the DD transplant patient subsequently developed acute tubular necrosis and was eventually lost within 3 weeks due to thrombotic microangiopathy and severe acute antibody-mediated rejection despite adequate immunosuppression. Non-cardiogenic pulmonary edema is a potentially devastating post-operative complication of basiliximab induction therapy in young pediatric patients following renal transplantation. Early recognition and appropriate supportive therapy is vital for patient and, where possible, graft survival.
Item Type:
Article
Language:
en
MeSH:
Acute Disease; Antibodies, Monoclonal; Child; Humans; Immunosuppressive Agents; Kidney Transplantation; Kidney Tubules, Distal; Living Donors; Male; Necrosis; Pulmonary Edema; Recombinant Fusion Proteins; Retrospective Studies; Tissue Donors; Transplantation, Homologous; Treatment Failure; Treatment Outcome
ISSN:
1432-198X

Full metadata record

DC FieldValue Language
dc.contributor.authorDolan, Niamhen_GB
dc.contributor.authorWaldron, Maryen_GB
dc.contributor.authorO'Connell, Marieen_GB
dc.contributor.authorEustace, Nicken_GB
dc.contributor.authorCarson, Kevinen_GB
dc.contributor.authorAwan, Atifen_GB
dc.date.accessioned2012-12-20T10:17:42Z-
dc.date.available2012-12-20T10:17:42Z-
dc.date.issued2009-11-
dc.identifier.citationBasiliximab induced non-cardiogenic pulmonary edema in two pediatric renal transplant recipients. 2009, 24 (11):2261-5 Pediatr. Nephrol.en_GB
dc.identifier.issn1432-198X-
dc.identifier.pmid19649661-
dc.identifier.doi10.1007/s00467-009-1244-4-
dc.identifier.urihttp://hdl.handle.net/10147/263318-
dc.description.abstractWe report two cases of non-cardiogenic pulmonary edema as a complication of basiliximab induction therapy in young pediatric renal transplant patients identified following a retrospective review of all pediatric renal transplant cases performed in the National Paediatric Transplant Centre, Childrens University Hospital, Temple Street, Dublin, Ireland. Twenty-eight renal transplantations, of which five were living-related (LRD) and 23 were from deceased donors (DD), were performed in 28 children between 2003 and 2006. In six cases, transplantations were pre-emptive. Immunosuppression was induced pre-operatively using a combination of basiliximab, tacrolimus and methylprednisolone in all patients. Basiliximab induction was initiated 2 h prior to surgery in all cases and, in 26 patients, basiliximab was re-administered on post-operative day 4. Two patients, one LRD and one DD, aged 6 and 11 years, respectively, developed acute non-cardiogenic pulmonary edema within 36 h of surgery. Renal dysplasia was identified as the primary etiological factor for renal failure in both cases. Both children required assisted ventilation for between 4 and 6 days. While both grafts had primary function, the DD transplant patient subsequently developed acute tubular necrosis and was eventually lost within 3 weeks due to thrombotic microangiopathy and severe acute antibody-mediated rejection despite adequate immunosuppression. Non-cardiogenic pulmonary edema is a potentially devastating post-operative complication of basiliximab induction therapy in young pediatric patients following renal transplantation. Early recognition and appropriate supportive therapy is vital for patient and, where possible, graft survival.en_GB
dc.language.isoenen
dc.rightsArchived with thanks to Pediatric nephrology (Berlin, Germany)en_GB
dc.subject.meshAcute Disease-
dc.subject.meshAntibodies, Monoclonal-
dc.subject.meshChild-
dc.subject.meshHumans-
dc.subject.meshImmunosuppressive Agents-
dc.subject.meshKidney Transplantation-
dc.subject.meshKidney Tubules, Distal-
dc.subject.meshLiving Donors-
dc.subject.meshMale-
dc.subject.meshNecrosis-
dc.subject.meshPulmonary Edema-
dc.subject.meshRecombinant Fusion Proteins-
dc.subject.meshRetrospective Studies-
dc.subject.meshTissue Donors-
dc.subject.meshTransplantation, Homologous-
dc.subject.meshTreatment Failure-
dc.subject.meshTreatment Outcome-
dc.titleBasiliximab induced non-cardiogenic pulmonary edema in two pediatric renal transplant recipients.en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Nephrology, Children's University Hospital, Dublin, Ireland. dolanniamh@eircom.neten_GB
dc.identifier.journalPediatric nephrology (Berlin, Germany)en_GB
dc.description.provinceLeinsteren

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