Long-term results of renal transplantation in children.

The results of renal transplantation in 37 children, 3 through 16 years of age, who received transplants prior to June, 1970 in our center, were examined. Twenty-three received kidneys from living-related donors and 14 received kidneys from cadaver donors. Patient survival rates were 78% at 10 years and 68% at 20 to 26 years. Graft survival rates were 56% at 10 years, 31% at 20 years, and 23% at 22 to 26 years. Twenty children received on or more retransplants. At follow-up, 23 (62%) of the patients had functioning grafts and two (5%) were undergoing dialysis. Cataracts, hypertension, and aseptic necrosis of bone were the most common medical complications and most of the patients were more than two standard deviations below average height. Most enjoyed good rehabilitation, however: more than 70% were employed or performing full time housework, more than 50% were married, 24% had children, and all had normal activity at least part of the time. These results, achieved with immunosuppressive methods now considered obsolete, indicate that renal transplantation is a satisfactory long-term treatment for children with renal failure.