Abstract
14 children, 5 to 14 years old, received cadaveric renal kidneys during 1973. Donors were 2 to 41 years old. Kidney size was greater than normal for the recipient in 9 cases, less in 3 cases, and equivalent in 2 cases. When too large to be placed in the pelvis, the kidney was placed in a paravertebral position. Uretero-ureteral anastomosis was performed in most cases. Treatment was Azathioprine and corticotherapy. High doses of Furosemide (10 mg/kg) during operation prevented ischemia acute renal failure, despite cold ischemia as long 23 hours. One child died after 1 week from intracerebral hemorrhage due to severe hypertension. A second died after 5 weeks from a diffuse hemorrhagic syndrome. Primary thrombosis of the kidney vessels led to transplantectomy in 1 case. Kidney function is normal in 9 cases, chronic rejection is present in 2. Ho urologic complications were observed. Hypertension developped in half of the children. One case was associated with renal artery stenosis, another with chronic rejection. Hypertension was more frequent in those who had severe hypertension, leading to binephrectomy, before transplantation. No correlation was found between occurence of hypertension and kidney size. Although follow-up is too short, growth appears possible in prepubertal children, when steroid doses are low. Rehabilitation was total within 3 months in 10 cases. Cadaveric kidney transplantation seems to be a valuable therapeutic procedure in children with chronic renal failure.
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Loirat, C., Broyer, M. Renal transplantation in children. First year experience. Pediatr Res 8, 901 (1974). https://doi.org/10.1203/00006450-197411000-00039
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DOI: https://doi.org/10.1203/00006450-197411000-00039