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Original ArticleOpen Access
Pediatric Kidney Transplantation : Siriraj Hospital Experience
Sumboonnanonda A 
,
Lertakyamanee J ,
Vongjirad A ,
Suntompoch V ,
Jitpraphai P
,
Lertakyamanee J ,
Vongjirad A ,
Suntompoch V ,
Jitpraphai P JARIYA LERTAKYAMANEE, M.D.**,
VIBUL SUNTORNPOCH, M.D.*,
We reported six children with end stage renal disease (ESRD) who received kidney trans-
plantation in our unit from 1996 to 2000. They were 5 boys and 1 girl and their mean age was
9.7เธ‘2.7 years (range 6.8 to 13.2). Etiologies of ESRD were congenital anomalies (3 patients),
chronic glomerulonephritis (2 patients), and rapidly progressive glomerulonephritis ( 1 patient).
Prior to the transplantation, chronic peritoneal dialysis was used in 5 patients, including one who
had to switch to hemodialysis due to chronic exit site infection and 1 had preemptive kidney trans-
plantation.
All children received a kidney from living-related donors, 4 from their fathers, 1 from
his mother, and 1 from his elder brother. Triple immunosuppressive drug therapy (prednisolone,
azathioprine, and cyclosporine A) was initially given to all patients. Serum creatinine returned to
normal within the first week in all patients and 4 patients were discharged home by the end of the
second week post operation. Immediate complications included severe hypertension (all patients),
ureteral leakage (2 patients), neutropenia (3 patients) and nephrotic syndrome (1 patient). Azathio-
prine was discontinued in 2 patients due to persistent neutropenia. Cyclosporine A was disconti-
nued in 1 patient due to hepatotoxicity, this patient was maintained on mycophenolate mofetil and
prednisolone. Serum creatinine levels at last follow-up (mean 24.3เธ‘19.0 months, range 8-55) were
normal in 5 patients and slightly increased ( 1.5 mg/dl) in one. Five patients returned to school
full time within 1 year after kidney transplantation. Height standard deviation score improved
markedly as early as 6 months post transplant. The cost of maintenance of the immunosuppres-
sive drugs was similar to adults, i.e. 6,859.1เธ‘1,151.8 Baht per month at 6 months post kidney
transplantation.
Vol.84 No.8
PEDIATRIC KIDNEY TRANSPLANTATION: SIRIRAJ HOSPITAL EXPERIENCE
1085
We concluded that kidney transplantation can be performed successfully in selected Thai
children with very good results and similar cost of treatment as for adults.
Key word : Pediatric Kidney Transplantation, Renal Replacement Therapy, End Stage Renal Disease
VIBUL SUNTORNPOCH, M.D.*,
We reported six children with end stage renal disease (ESRD) who received kidney trans-
plantation in our unit from 1996 to 2000. They were 5 boys and 1 girl and their mean age was
9.7เธ‘2.7 years (range 6.8 to 13.2). Etiologies of ESRD were congenital anomalies (3 patients),
chronic glomerulonephritis (2 patients), and rapidly progressive glomerulonephritis ( 1 patient).
Prior to the transplantation, chronic peritoneal dialysis was used in 5 patients, including one who
had to switch to hemodialysis due to chronic exit site infection and 1 had preemptive kidney trans-
plantation.
All children received a kidney from living-related donors, 4 from their fathers, 1 from
his mother, and 1 from his elder brother. Triple immunosuppressive drug therapy (prednisolone,
azathioprine, and cyclosporine A) was initially given to all patients. Serum creatinine returned to
normal within the first week in all patients and 4 patients were discharged home by the end of the
second week post operation. Immediate complications included severe hypertension (all patients),
ureteral leakage (2 patients), neutropenia (3 patients) and nephrotic syndrome (1 patient). Azathio-
prine was discontinued in 2 patients due to persistent neutropenia. Cyclosporine A was disconti-
nued in 1 patient due to hepatotoxicity, this patient was maintained on mycophenolate mofetil and
prednisolone. Serum creatinine levels at last follow-up (mean 24.3เธ‘19.0 months, range 8-55) were
normal in 5 patients and slightly increased ( 1.5 mg/dl) in one. Five patients returned to school
full time within 1 year after kidney transplantation. Height standard deviation score improved
markedly as early as 6 months post transplant. The cost of maintenance of the immunosuppres-
sive drugs was similar to adults, i.e. 6,859.1เธ‘1,151.8 Baht per month at 6 months post kidney
transplantation.
Vol.84 No.8
PEDIATRIC KIDNEY TRANSPLANTATION: SIRIRAJ HOSPITAL EXPERIENCE
1085
We concluded that kidney transplantation can be performed successfully in selected Thai
children with very good results and similar cost of treatment as for adults.
Key word : Pediatric Kidney Transplantation, Renal Replacement Therapy, End Stage Renal Disease
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