[Results of 310 cadaver kidney transplants in children and adolescents].

This study reports the results of 310 cadaver kidney transplantations in 295 children and adolescents performed from 1973 to 1983. The actuarial survival of patients was 97% at one year and 92% at 5 years; that of grafts was 79% at 1 year and 65% at 5 years, these rates having improved during the last years. Results were similar and even better for the 18 second transplantations. Among the causes of failure, rejection comes first (65%), then thromboses of renal artery (13%) and relapses of oxalosis or steroid resistant nephrosis (12%). Patients with cytotoxic antibodies have a less good survival of grafts, especially after 5 years. HLA A and B compatibility is a factor of success. Among complications hypertension is frequent, 53% of patients receiving antihypertensive treatment after 1 year. It is sometimes severe and was responsible for death in 5 cases. Growth was variable after transplantation: 25% of children before puberty had a catch-up curve, 25% had an unchanged growth and 50% an increased retardation. The average standard deviation was near zero but it was -0.49 SD/year in patients with creatinine level greater than or equal to 150 mumol and +0.24 SD in children under alternate day steroid therapy. Rehabilitation was excellent, less than 3% of patients not being engaged in any activity 1 year after transplantation.