Mohamed S Al Riyami1, Sulaiman Al Saidi1, Badria Al Ghaithi1, Anisa Al Maskari1, Sadiq Lala2, Nabil Mohsin3, Lekha Hirshikesan4, Naifain Al Kalbani1. 1. Pediatric Nephrology Unit, Department of Child Health, Royal Hospital, Muscat, Oman. 2. Urology Unit, Department of Surgery, Royal Hospital, Muscat, Oman. 3. Department of Medicine, College of Medicine, Sultan Qaboos University, Muscat, Oman. 4. Department of Nephrology Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala, India.
Abstract
OBJECTIVES: This study sought to report 22 years experience in pediatric kidney transplantation in Oman. METHODS: Electronic charts of all Omani children below 13 years of age who received a kidney transplant from January 1994 to December 2015 were reviewed. Data collected included patient demographics, etiology of end-stage kidney disease, modality and duration of dialysis, donor type, complication of kidney transplantation (including surgical complications, infections, graft rejection) graft and patient survival, and duration of follow-up. RESULTS: During the study period transplantation from 27 living related donors (LRDs), 42 living unrelated donors (LURDs), also referred to as commercial transplant, and one deceased donor were performed. The median age at transplantation was nine years for both groups. The most common primary diagnosis was congenital anomalies of the kidney and urinary tract in 32.8% of patients followed by familial nephrotic syndrome in 20.0% and polycystic kidney disease in 18.5%. Almost half the patients were on hemodialysis before transplantation, 35.7% were on peritoneal dialysis, and 14.2% received preemptive renal transplantation. Children who received LURD kidneys had high surgical complications (42.8%) compared to the LRDs group (17.8%). Five patients from LURDs group had early graft nephrectomy and four patients developed non-graft function or delayed graft function. In addition, patients in the LURDs group had a higher incidence of hypertension and acute rejection. Graft and patient survival were both better in the LRDs than the LURDs group. CONCLUSIONS: Although our pediatric kidney transplant program is a young program it has had successful patient outcomes comparable to international programs. Our study provides evidence that in addition to legal and ethical issues with commercial transplant, it also carries significantly higher morbidity and reduced graft and patient survival.
OBJECTIVES: This study sought to report 22 years experience in pediatric kidney transplantation in Oman. METHODS: Electronic charts of all Omani children below 13 years of age who received a kidney transplant from January 1994 to December 2015 were reviewed. Data collected included patient demographics, etiology of end-stage kidney disease, modality and duration of dialysis, donor type, complication of kidney transplantation (including surgical complications, infections, graft rejection) graft and patient survival, and duration of follow-up. RESULTS: During the study period transplantation from 27 living related donors (LRDs), 42 living unrelated donors (LURDs), also referred to as commercial transplant, and one deceased donor were performed. The median age at transplantation was nine years for both groups. The most common primary diagnosis was congenital anomalies of the kidney and urinary tract in 32.8% of patients followed by familial nephrotic syndrome in 20.0% and polycystic kidney disease in 18.5%. Almost half the patients were on hemodialysis before transplantation, 35.7% were on peritoneal dialysis, and 14.2% received preemptive renal transplantation. Children who received LURD kidneys had high surgical complications (42.8%) compared to the LRDs group (17.8%). Five patients from LURDs group had early graft nephrectomy and four patients developed non-graft function or delayed graft function. In addition, patients in the LURDs group had a higher incidence of hypertension and acute rejection. Graft and patient survival were both better in the LRDs than the LURDs group. CONCLUSIONS: Although our pediatric kidney transplant program is a young program it has had successful patient outcomes comparable to international programs. Our study provides evidence that in addition to legal and ethical issues with commercial transplant, it also carries significantly higher morbidity and reduced graft and patient survival.
Entities:
Keywords:
Living Donors; Oman; Pediatrics; Renal Transplantation
Authors: Jagbir Gill; Bhaskara R Madhira; David Gjertson; Gerald Lipshutz; J Michael Cecka; Phuong-Thu Pham; Alan Wilkinson; Suphamai Bunnapradist; Gabriel M Danovitch Journal: Clin J Am Soc Nephrol Date: 2008-10-15 Impact factor: 8.237
Authors: H A Gritsch; J L Veale; A B Leichtman; M K Guidinger; J C Magee; R A McDonald; W E Harmon; F L Delmonico; R B Ettenger; J M Cecka Journal: Am J Transplant Date: 2008-10 Impact factor: 8.086