Long-term outcome of intensive initial immunosuppression protocol in pediatric deceased donor renal transplantation.
Olaitan, Oyedolamu K Zimmermann, Jose A Shields, William P Rodriguez-Navas, Guillermo Awan, Atif Mohan, Ponnusamy Little, Dilly M Hickey, David P
Olaitan, Oyedolamu K
Zimmermann, Jose A
Shields, William P
Rodriguez-Navas, Guillermo
Awan, Atif
Mohan, Ponnusamy
Little, Dilly M
Hickey, David P
Advisors
Editors
Other Contributors
Date
2010-02
Date Submitted
Keywords
Other Subjects
Subject Mesh
Adolescent
Adult
Aged
Child
Child, Preschool
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Immunosuppression
Immunosuppressive Agents
Ireland
Kidney Transplantation
Male
Middle Aged
Retrospective Studies
Risk Factors
Survival Rate
Time Factors
Tissue Donors
Treatment Outcome
Young Adult
Adult
Aged
Child
Child, Preschool
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Immunosuppression
Immunosuppressive Agents
Ireland
Kidney Transplantation
Male
Middle Aged
Retrospective Studies
Risk Factors
Survival Rate
Time Factors
Tissue Donors
Treatment Outcome
Young Adult
Planned Date
Start Date
Collaborators
Principal Investigators
Alternative Titles
Publisher
Abstract
To report the long-term outcome of deceased donor kidney transplantation in children with emphasis on the use of an intensive initial immunosuppression protocol using R-ATG as antibody induction. Between January 1991 and December 1997, 82 deceased donor kidney transplantations were performed in 75 pediatric recipients. Mean recipient age at transplantation was 12.9 yr and the mean follow-up period was 12.6 yr. All patients received quadruple immunosuppression with steroid, cyclosporine, azathioprine, and antibody induction using R-ATG-Fresenius. Actual one, five, and 10 yr patient survival rates were 99%, 97%, and 94%, respectively; only one patient (1.2%) developed PTLD. Actual one, five, and 10 yr overall graft survival rates were 84%, 71%, and 50%, respectively; there were five cases (6%) of graft thrombosis and the actual immunological graft survival rates were 91%, 78%, and 63% at one, five, and 10 yr, respectively. The use of an intensive initial immunosuppression protocol with R-ATG as antibody induction is safe and effective in pediatric recipients of deceased donor kidneys with excellent immunological graft survival without an increase in PTLD or other neoplasms over a minimum 10-yr follow up.
Language
en
ISSN
1399-3046
eISSN
ISBN
DOI
10.1111/j.1399-3046.2009.01138.x
PMID
19309452