All issues > Volume 30(12); 1987

Original Article

J Korean Pediatr Soc. 1987;30(12):1419-1432. Published online December 31, 1987.

6 Cases of Renal Transplantation in Children.

Pyung Kil Kim¹, Fan Chen Mong¹, Jae Seung Lee¹, Kill Park², Dae Seuk Han³

¹Department of Pediatrics, Yousei University, College of Medicine, Seoul, Korea
²Department of Surgery, Yousei University, College of Medicine, Seoul, Korea
³Department of Internal Medicine, Yousei University, College of Medicine, Seoul, Korea

Abstract

The incidence of end stage renal disease (ESRD) in childhood seems to be around two to three children per million population per year and the most frequent diagnoses of ESRD in pre-teen patients are congenital and dysplastic diseases. Renal transplantation may be the preferred method for the treatment of ESRD especially in children not only becauses of better development and linear growth, but also for good psychological and social adaptation. Among the 6 patients receiving renal transplants, the diagnoses of renal disease revelaed one case of chronic glomerulonephritis with vesicoureteral reflux, one focal glomerulosclerosis, one chronic pyelonephritis. Among the remaining 3 patients with no pathologic specimen, the diagnoses were one cases of vesicoureteral reflux, one case of nephrotic syndrome, and one with no definite etiology. Rejection episodes occurred in two patients, one had received a kidney from a living unrelated donor and the other whose transplant came from patienfs mother. Acute rejection occurred in both patients 1 month after surgery, but was resolved by steroid alone or with local irradiation. Immunosuppressants administered during the posttransplant period include prednisone, imuran, and cyclosporine (CsA). CsA, a potent immunosuppressive agent with fewer side effects has been used in 4 patients. Nephrectomy was performed concomitantly in 3 patients, one with heavy proteinuria and hyperten- sion, and in two patients with vesicoureteral reflux. All patients except one presented with well functioning allografts during the follow up period of 5 months to 6 8/12 years. That one patient refused further treatment when chronic rejection developed 4 years after the transplant. As renal transplantation is rarely performed in children with ESRD in Korea, there has been no available data since Kim et al. reported the first case in 1980. However, because of its great advantages over dialysis, the authors suggest that it should be employed more widely with ESRD children.

Keywords :Renal transplantation in children.