PMID- 24495971
OWN - NLM
STAT- MEDLINE
DCOM- 20150828
LR  - 20211203
IS  - 1873-4898 (Electronic)
IS  - 1477-5131 (Linking)
VI  - 10
IP  - 4
DP  - 2014 Aug
TI  - Surgical complications and graft function following live-donor extraperitoneal 
      renal transplantation in children 20 kg or less.
PG  - 737-43
LID - S1477-5131(14)00006-0 [pii]
LID - 10.1016/j.jpurol.2013.12.013 [doi]
AB  - OBJECTIVES: To evaluate the effect of patient, surgical, and medical factors on 
      surgical complications and graft function following renal transplantation (Tx) in 
      children weighing </= 20 kg, because the number of this challenging group of 
      children is increasing. PATIENTS AND METHODS: Between June 2009 and October 2013, 
      26 patients received living donor renal allotransplant using the extraperitoneal 
      approach (EPA). The immunosuppression regimen was composed of prednisolone, 
      mycophenolate mofetil, and ciclosporin or tacrolimus. RESULTS: The mean weight 
      was 16.46 +/- 2.61 kg. Mean cold ischemia time was 53.85 +/- 12.35 min. The graft 
      survival rate (GSR) and patient survival rate (PSR) were 96% at 3 years. Acute 
      rejection episodes (AREs) occurred in eight patients (30%). Postoperative 
      surgical complications were ureteral leakage (3), vesicoureteric reflux (2), and 
      renal vein thrombosis (2) (with one graft nephrectomy). Mean follow-up was 37.5 +/- 
      7.4 months. CONCLUSION: Excellent PSR and GSR can be achieved in low weight (<20 
      kg) recipients. Even in very low weight patients, the EPA was used. No cases were 
      reported with primary graft non-function due to use of living donors, increasing 
      pre-Tx body weight to at least 10 kg and maintaining adequate filling pressure 
      before graft reperfusion. The presence of related donors and use of induction 
      therapy and tacrolimus decreased the rate of ARE while the presence of pre-Tx 
      lower urinary tract surgical interventions increased the rate of ureteric 
      complications, but this was statistically insignificant.
CI  - Copyright (c) 2014 Journal of Pediatric Urology Company. Published by Elsevier Ltd. 
      All rights reserved.
FAU - ElSheemy, Mohammed S
AU  - ElSheemy MS
AD  - Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, 
      Cairo, Egypt. Electronic address: mohammedshemy@yahoo.com.
FAU - Shouman, Ahmed M
AU  - Shouman AM
AD  - Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, 
      Cairo, Egypt.
FAU - Shoukry, Ahmed I
AU  - Shoukry AI
AD  - Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, 
      Cairo, Egypt.
FAU - Soaida, Sherif
AU  - Soaida S
AD  - Division of Pediatric Anesthesia, Aboul-Riche Children's Hospital, Cairo 
      University, Cairo, Egypt.
FAU - Salah, Doaa M
AU  - Salah DM
AD  - Division of Pediatric Nephrology, Aboul-Riche Children's Hospital, Cairo 
      University, Cairo, Egypt.
FAU - Yousef, Ali M
AU  - Yousef AM
AD  - Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, 
      Cairo, Egypt.
FAU - Morsi, Hany A
AU  - Morsi HA
AD  - Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, 
      Cairo, Egypt.
FAU - Fadel, Fatina I
AU  - Fadel FI
AD  - Division of Pediatric Nephrology, Aboul-Riche Children's Hospital, Cairo 
      University, Cairo, Egypt.
FAU - Sadek, Sameh Z
AU  - Sadek SZ
AD  - Urology Department, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.
LA  - eng
PT  - Journal Article
DEP - 20140115
PL  - England
TA  - J Pediatr Urol
JT  - Journal of pediatric urology
JID - 101233150
SB  - IM
MH  - Adult
MH  - *Body Weight
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Female
MH  - Graft Rejection/*epidemiology
MH  - Graft Survival
MH  - Humans
MH  - Immunosuppression Therapy
MH  - Kidney Failure, Chronic/etiology/mortality/*surgery
MH  - Kidney Transplantation/*adverse effects/methods/mortality
MH  - *Living Donors
MH  - Male
MH  - Middle Aged
MH  - Survival Rate
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Extraperitoneal approach
OT  - Live donor
OT  - Low body weight children
OT  - Pediatric
OT  - Renal transplantation
EDAT- 2014/02/06 06:00
MHDA- 2015/09/01 06:00
CRDT- 2014/02/06 06:00
PHST- 2013/10/27 00:00 [received]
PHST- 2013/12/13 00:00 [accepted]
PHST- 2014/02/06 06:00 [entrez]
PHST- 2014/02/06 06:00 [pubmed]
PHST- 2015/09/01 06:00 [medline]
AID - S1477-5131(14)00006-0 [pii]
AID - 10.1016/j.jpurol.2013.12.013 [doi]
PST - ppublish
SO  - J Pediatr Urol. 2014 Aug;10(4):737-43. doi: 10.1016/j.jpurol.2013.12.013. Epub 
      2014 Jan 15.