ESPN 51th Annual Meeting

ESPN 2018


 
Kidney transplantation and other methods of renal replacement therapy in children: 30 years of observations in one center
ANNA MEDYNSKA 1 KATARZYNA KILIS-PSTRUSINSKA 1 IRENA MAKULSKA 1 DANUTA ZWOLINSKA 1

1- DPT. OF PEDIATRIC NEPHROLOGY, MEDICAL UNIVERSITY, WROCLAW
 
Introduction:

Kidney transplantation is regarded as the optimal treatment method for renal replacement therapy (RRT) for end-stage renal disease (ESRD) patients. Children qualified for kidney transplantation should receive the organ as soon as possible in order to improve their chances for healthy development and an improved quality of life. In our center,  RRT for children with ESRD has been conducted for 35 years: hemodialysis (HD) since 1982, peritoneal dialysis (PD) since 1992, and the first transplant in 1987.

 

Material and methods:

The aim of this study was to assess kidney transplant treatment in children with ESRD in comparison with other methods of chronic RRT. We analyzed the data of patients treated between 1987 and 2017; in particular, we compared the transplants conducted over the three subsequent decades.

 

Results:

In the period analyzed, 153 children aged from 2 weeks to 18 years were dialyzed. The mean age of the start of RRT was 9.4 years.

In 80 children (52.2%), the method utilized first was HD; in 73 patients (47.7%), it was PD. In 25 children, the type of dialysis was changed.

Kidney transplantation was performed in 40%, 60.34%, and 73% of patients dialyzed in the periods 1987–1996, 1997–2006, and 2007–2017, respectively. The average waiting time for a transplant in the above-mentioned decades was: 2.25, 2.65, and 1.97 years (range: 6 months–10 years). Three children underwent transplantation with a family donor; 1 boy received a transplanted kidney and liver. Two children underwent a pre-emptive transplant from a deceased donor.

 

Conclusions:

The percentage of children with ESRD who are treated with renal transplantation continues to increase, but in our assessment it still remains too low. Only in individual cases, family transplants and pre-emptive transplants are performed. It is necessary to escalate the efforts which can shorten the waiting time for a kidney transplant.