|
Hokkaido University Collection of Scholarly and Academic Papers >
Hokkaido University Hospital >
Peer-reviewed Journal Articles, etc >
Pediatric kidney transplantation is safe and available for patients with urological anomalies as well as those with primary renal diseases
Title: | Pediatric kidney transplantation is safe and available for patients with urological anomalies as well as those with primary renal diseases |
Authors: | Morita, Ken Browse this author | Iwami, Daiki Browse this author →KAKEN DB | Hotta, Kiyohiko Browse this author | Shimoda, Naohiko Browse this author →KAKEN DB | Miura, Masayoshi Browse this author | Watarai, Yoshihiko Browse this author →KAKEN DB | Hoshii, Sakurako Browse this author | Obikane, Katsuyuki Browse this author →KAKEN DB | Nakashima, Taiji Browse this author | Sasaki, Satoshi Browse this author →KAKEN DB | Nonomura, Katsuya Browse this author →KAKEN DB |
Keywords: | graft survival | kidney transplantation | pediatric | urological anomaly | outcome |
Issue Date: | Mar-2009 |
Publisher: | Wiley-Blackwell |
Journal Title: | Pediatric Transplantation |
Volume: | 13 |
Issue: | 2 |
Start Page: | 200 |
End Page: | 205 |
Publisher DOI: | 10.1111/j.1399-3046.2008.00992.x |
PMID: | 18662371 |
Abstract: | The aim of the current study was to evaluate long-term outcomes of pediatric live kidney transplantation in patients with genitourinary anomalies relative to those with primary kidney diseases. The study included 35 pediatric patients who received a live kidney transplantation during the last 25 yr (28 males, six females). Median age at the time of transplantation was nine yr (range 1–15 yr), and the median follow-up period was 151 months (range 6–239 month). The patients were divided into two groups. The urological group (n = 14) included patients with primary obstructive/reflux nephropathy. The renal group (n = 20) included patients with primary renal disorders. Differences between groups in graft survival, clinical course, and final graft function were evaluated. Original diseases represented in the urological group included five cases with primary VUR and eight cases with secondary VUR. Diseases in the renal group included eight cases with bilateral hypo-dysplastic kidney, three cases with focal/segmental glomerular sclerosis, two cases with membranous proliferative glomerulonephritis, two cases with congenital nephrotic syndrome and five cases with other forms of chronic nephritis. Ten of 14 cases in the urological group, relative to six of 20 in the renal group, were preemptive. Median age at transplantation was 7.5 or 10 yr old, respectively, in the urological or renal group. Twelve kidney recipients in the urological group had also undergone other urinary surgeries, including upper urinary tract drainage, ureteroneocystostomy, augmentation cystoplasty, endoscopic incision of posterior-urethral valve, urethroplasty, etc. Cumulative post-operative complications occurred in nine or 16, respectively, in the urological or renal group. The acute rejection free and overall graft survival were similar in both groups. One patient in the urological group lost his graft while six patients in the renal group lost their grafts. Thus, the post-transplant clinical outcome of pediatric transplantation in patients with urological anomalies is comparable to that of recipients with primary renal disease. Appropriate urinary tract reconstruction and management is essential to reduce the risk of graft dysfunction because of urinary problems. |
Rights: | This is the pre-peer reviewed version of the following article: Morita K, Iwami D, Hotta K, Shimoda N, Miura M, Watarai Y, Hoshii S, Obikane K, Nakashima T, Sasaki S, Nonomura K. Pediatric kidney transplantation is safe and available for patients with urological anomalies as well as those with primary renal diseases. Pediatr Transplantation 2009: 13: 200–205, which has been published in final form at http://dx.doi.org/10.1111/j.1399-3046.2008.00992.x |
Type: | article (author version) |
URI: | http://hdl.handle.net/2115/53070 |
Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
|
Submitter: 森田 研
|