Pediatric kidney transplantation: a single center experience.

Background: Kidney transplantation has become the routine treatment for the pediatric population suffering from end stage renal disease (ESRD). The aim of this study was to investigate the case characteristics and the long-term outcomes in this patient group. Methods: In our Center, the program for pediatric transplant began on January 1987, once a satisfactory experience had been acquired in adults. Up until January 2010, 1392 transplants had been accomplished; 341 of these (315 from cadaveric donors and 26 from living – related donors) were performed in recipients being under 21 years of age (mean age 13.6±5.5 yrs). Results: The patient survival rates at 1 year, 5 and 10 years were 98.5%, 97.2%, 94.1%, respectively. At the same time points, the graft survival rates were 94.9%, 89.8%, and 80.6%, respectively. A double-drug regimen was used before 1990; this was replaced by a triple–drug regimen including a calcineurin inhibitor in 1991. Eighty-seven (26%) grafts were lost, 54% as a result of immunological and the rest as a result of non–immunological causes; 18 recipients (5%) died during the follow-up period. Bacterial infections were the main cause of patient loss; surgical complications, immunological reasons and recurrent disease were for graft loss. Conclusions: Long–term survival in children was better than reports in adult renal transplant recipients. This finding suggests that pediatric kidney transplantation may offer favorable graft outcomes.