J Med Assoc Thai 2009; 92 (12):1635

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Pediatric Renal Transplantation: A Single-Center Experience in Northeast Thailand
Wisanuyotin S Mail, Jiravuttipong A

Objective: To clarify the demographic data, outcomes and complications of renal transplantation in children
at Srinagarind (university) Hospital.

Material and Method: The authors reviewed the medical records of children with end-stage renal disease
(ESRD) who received renal transplantation at Srinagarind Hospital, Khon Kaen, between August 2001 and
July 2008.

Results: Eight male and seven female patients were identified. Their mean age was 12.8 + 3.2 years (range,
5.0-17.6). The major cause of ESRD was a congenital anomaly of the kidneys (53%). All of the children
received cadaveric transplantations and none received induction therapy. Triple immunosuppressive drugs
comprising cyclosporine, prednisolone and mycophenolate mofetil were administered to 12 patients. Tacrolimus,
instead of cyclosporine, was given to three patients who had received a renal transplant since January 2008.
The median follow-up time was 15 months (3 to 82 months). The most frequent complication was urinary tract
infection (40%). Acute graft loss was found in one patient (6.7%) due to graft infarction. Other complications
included herpes viral infection, chronic rejection, acute rejection, severe gingival hyperplasia, myopathy,
lymphocele and transitional cell carcinoma of the bladder. Two patients returned to dialysis due to graft
infarction and chronic rejection, respectively. The mean serum creatinine at the last follow-up of the remaining
cases was 1.2 + 0.5 mg/dL (range, 0.6-2.3). All of the patients survived. The 1- and 5-year graft survival
rates were 93.3% and 86.7%, respectively.

Conclusion: The present study demonstrates the potential for successful outcomes of pediatric renal
transplantation in this resource-limited area.

Keywords: Renal transplantation, Children, Complication, End-stage renal disease

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