PMID- 10084732
OWN - NLM
STAT- MEDLINE
DCOM- 19990401
LR  - 20041117
IS  - 1397-3142 (Print)
IS  - 1397-3142 (Linking)
VI  - 2
IP  - 4
DP  - 1998 Nov
TI  - Renal graft survival in children with early acute rejection.
PG  - 294-8
AB  - Acute rejection episodes (AREs) are an important cause of morbidity and mortality 
      in children following renal transplantation. For the purpose of this study, the 
      diagnosis of early rejection was established when it developed within the first 6 
      months post-transplantation. The impact of an early ARE on patient and graft 
      survival areas was studied in 44 patients who received their grafts between 
      January 1987 and December 1995. Group I (GI) was comprised of 25 patients who 
      developed 30 ARE. They were compared to 19 age- and sex-matched controls without 
      ARE, group II (GII), who were transplanted during the same time-period and 
      received similar long-term immunosuppressive triple therapy, oral prednisone, 
      azathioprine and cyclosporine A. The ARE was confirmed by renal biopsy in 83% of 
      the cases. Morbidity, mortality and graft function were assessed statistically at 
      baseline, 12 and 24 months after transplantation. Seven GI patients lost their 
      grafts during an ARE; in 4 cases death that was related to opportunistic 
      infections presenting during or soon after anti-rejection therapy, whereas 3 
      patients who survived lost their grafts due to thromboses or infections, also as 
      a consequence of ARE. The GI graft survival rates were 76% and 72% at 12 and 24 
      months post-transplant, respectively, whereas the graft survival rate of GII 
      patients was 100% at both evaluation periods. The patient survival rate was 84% 
      in GI and 100% in GII patients at 24 months. No statistically significant 
      differences of renal function were found between and/or within groups at 12 and 
      24 months. Recipients of living related donor (LRD) and cadaveric donor (CD) 
      kidneys were evaluated independently of the group to which they were allocated. 
      The acute rejection ratio (number of AREs/number of transplants) was 0.61 in LRD 
      and 0.38 in CD (differences non-significant). This study concludes that AREs are 
      an important cause of patient and graft loss, with opportunistic infections being 
      a major threat to be considered during aggressive anti-rejection therapy. The 
      renal function was normal after long-term follow-up in both groups of patients, 
      regardless of ARE.
FAU - Munoz, R
AU  - Munoz R
AD  - Department of Nephrology, Hospital Infantil de Mexico Federico Gomez, Mexico 
      City.
FAU - Romero, B
AU  - Romero B
FAU - Medeiros, M
AU  - Medeiros M
FAU - Zaragoza, L
AU  - Zaragoza L
LA  - eng
PT  - Journal Article
PL  - Denmark
TA  - Pediatr Transplant
JT  - Pediatric transplantation
JID - 9802574
RN  - 0 (Immunosuppressive Agents)
SB  - IM
CIN - Pediatr Transplant. 1998 Nov;2(4):254-6. PMID: 10084725
MH  - Acute Disease
MH  - Case-Control Studies
MH  - Cause of Death
MH  - Child
MH  - Female
MH  - Graft Rejection/diagnosis/*etiology/immunology/mortality
MH  - Graft Survival/*immunology
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Kidney Transplantation/*adverse effects/immunology
MH  - Male
MH  - Opportunistic Infections/complications
MH  - Survival Analysis
EDAT- 1999/03/20 00:00
MHDA- 1999/03/20 00:01
CRDT- 1999/03/20 00:00
PHST- 1999/03/20 00:00 [pubmed]
PHST- 1999/03/20 00:01 [medline]
PHST- 1999/03/20 00:00 [entrez]
PST - ppublish
SO  - Pediatr Transplant. 1998 Nov;2(4):294-8.