PMID- 3901376
OWN - NLM
STAT- MEDLINE
DCOM- 19851101
LR  - 20041117
IS  - 0039-6060 (Print)
IS  - 0039-6060 (Linking)
VI  - 98
IP  - 4
DP  - 1985 Oct
TI  - Improved results of multiple renal transplantation in children.
PG  - 729-38
AB  - The results of 289 renal transplants in 223 children performed at the University 
      of Minnesota during a 15-year period (1968 to 1982) were analyzed 
      retrospectively. We found no statistically significant difference in graft and 
      patient survival rates between 223 first, 50 second, and 13 third transplants. 
      Children with greater than 1 year primary graft function had a significantly 
      better second graft survival, especially when transplant nephrectomy was 
      unnecessary before retransplantation. Children with less than 1 year primary 
      graft function had a poorer second graft survival, particularly when the interval 
      between transplants was less than 1 year. To determine the current risk-benefit 
      factors in retransplantation in children, we compared two eras, our recent 7-year 
      experience with our earlier 8-year experience. First graft survival remained 
      essentially unchanged in both eras; however, graft survival rates of second 
      transplants significantly improved, from 58% to 77% at 2 years (p less than 
      0.04). Two-year graft survival rates for nonidentical related kidneys improved 
      from 73% to 82% and for cadaveric kidneys from 30% to 66%. Two-year graft 
      survival rates for human leukocyte antigen (HLA)-identical kidneys were 100% in 
      both eras. Better experience in patient care, abandonment of the practice of 
      early retransplantation in children with rapid loss of the primary graft, changes 
      in blood transfusion policy, and the use of better matched cadaveric kidneys 
      probably account for our improved results. In conclusion, current risk-benefits 
      for first and second transplants in children are the same. In our view, it is 
      unwarranted to maintain children on open-ended long-term dialysis because the 
      first graft has failed, although a period of maintenance dialysis to allow 
      recovery from the complications of the first graft seems justified.
FAU - So, S K
AU  - So SK
FAU - Simmons, R L
AU  - Simmons RL
FAU - Fryd, D S
AU  - Fryd DS
FAU - Najarian, J S
AU  - Najarian JS
FAU - Mauer, S M
AU  - Mauer SM
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Surgery
JT  - Surgery
JID - 0417347
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cadaver
MH  - Child
MH  - Child, Preschool
MH  - Graft Rejection
MH  - *Graft Survival
MH  - Histocompatibility Testing
MH  - Humans
MH  - Infant
MH  - Kidney/physiopathology
MH  - Kidney Failure, Chronic/mortality/*therapy
MH  - *Kidney Transplantation
MH  - Reoperation
MH  - Time Factors
MH  - Tissue Donors
EDAT- 1985/10/01 00:00
MHDA- 1985/10/01 00:01
CRDT- 1985/10/01 00:00
PHST- 1985/10/01 00:00 [pubmed]
PHST- 1985/10/01 00:01 [medline]
PHST- 1985/10/01 00:00 [entrez]
PST - ppublish
SO  - Surgery. 1985 Oct;98(4):729-38.