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Pediatric kidney transplantation is safe and available for patients with urological anomalies as well as those with primary renal diseases

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Title: Pediatric kidney transplantation is safe and available for patients with urological anomalies as well as those with primary renal diseases
Authors: Morita, Ken Browse this author
Iwami, Daiki Browse this author →KAKEN DB
Hotta, Kiyohiko Browse this author
Shimoda, Naohiko Browse this author →KAKEN DB
Miura, Masayoshi Browse this author
Watarai, Yoshihiko Browse this author →KAKEN DB
Hoshii, Sakurako Browse this author
Obikane, Katsuyuki Browse this author →KAKEN DB
Nakashima, Taiji Browse this author
Sasaki, Satoshi Browse this author →KAKEN DB
Nonomura, Katsuya Browse this author →KAKEN DB
Keywords: graft survival
kidney transplantation
pediatric
urological anomaly
outcome
Issue Date: Mar-2009
Publisher: Wiley-Blackwell
Journal Title: Pediatric Transplantation
Volume: 13
Issue: 2
Start Page: 200
End Page: 205
Publisher DOI: 10.1111/j.1399-3046.2008.00992.x
PMID: 18662371
Abstract: The aim of the current study was to evaluate long-term outcomes of pediatric live kidney transplantation in patients with genitourinary anomalies relative to those with primary kidney diseases. The study included 35 pediatric patients who received a live kidney transplantation during the last 25 yr (28 males, six females). Median age at the time of transplantation was nine yr (range 1–15 yr), and the median follow-up period was 151 months (range 6–239 month). The patients were divided into two groups. The urological group (n = 14) included patients with primary obstructive/reflux nephropathy. The renal group (n = 20) included patients with primary renal disorders. Differences between groups in graft survival, clinical course, and final graft function were evaluated. Original diseases represented in the urological group included five cases with primary VUR and eight cases with secondary VUR. Diseases in the renal group included eight cases with bilateral hypo-dysplastic kidney, three cases with focal/segmental glomerular sclerosis, two cases with membranous proliferative glomerulonephritis, two cases with congenital nephrotic syndrome and five cases with other forms of chronic nephritis. Ten of 14 cases in the urological group, relative to six of 20 in the renal group, were preemptive. Median age at transplantation was 7.5 or 10 yr old, respectively, in the urological or renal group. Twelve kidney recipients in the urological group had also undergone other urinary surgeries, including upper urinary tract drainage, ureteroneocystostomy, augmentation cystoplasty, endoscopic incision of posterior-urethral valve, urethroplasty, etc. Cumulative post-operative complications occurred in nine or 16, respectively, in the urological or renal group. The acute rejection free and overall graft survival were similar in both groups. One patient in the urological group lost his graft while six patients in the renal group lost their grafts. Thus, the post-transplant clinical outcome of pediatric transplantation in patients with urological anomalies is comparable to that of recipients with primary renal disease. Appropriate urinary tract reconstruction and management is essential to reduce the risk of graft dysfunction because of urinary problems.
Rights: This is the pre-peer reviewed version of the following article: Morita K, Iwami D, Hotta K, Shimoda N, Miura M, Watarai Y, Hoshii S, Obikane K, Nakashima T, Sasaki S, Nonomura K. Pediatric kidney transplantation is safe and available for patients with urological anomalies as well as those with primary renal diseases. Pediatr Transplantation 2009: 13: 200–205, which has been published in final form at http://dx.doi.org/10.1111/j.1399-3046.2008.00992.x
Type: article (author version)
URI: http://hdl.handle.net/2115/53070
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 森田 研

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