CLINICAL OUTCOMES OF PAEDIATRIC RENAL TRANSPLANTATION: A SINGLE CENTER EXPERIENCE

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CLINICAL OUTCOMES OF PAEDIATRIC RENAL TRANSPLANTATION: A SINGLE CENTER EXPERIENCE

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Co-author 1

DR SAAHITI SUNKARA sunkarasaahiti4@gmail.com NIZAM'S INSTITUTE OF MEDICAL SCIENCES NEPHROLOGY HYDERABAD India *

Co-author 2

DR PRASHANT KUMAR DIXIT dixitafmc@gmail.com NIZAM'S INSTITUTE OF MEDICAL SCIENCES NEPHROLOGY HYDERABAD India -

Co-author 3

DR VIJAY CHANDER BUKKA vijaychander@gmail.com NIZAM'S INSTITUTE OF MEDICAL SCIENCES NPEHROLOGY HYDERABAD India -

Co-author 4

DR SWARNALATHA GUDITI swarnamalli@gmail.com NIZAM'S INSTITUTE OF MEDICAL SCIENCES NEPHROLOGY HYDERABAD India -

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Introduction

Pediatric renal transplantation confers better survival and quality of life than dialysis, yet presents unique challenges in growth, graft longevity and immunosuppression. With growing awareness of organ donation and advances in surgical and medical care, its clinical success has improved markedly. This study analyses pediatric transplant outcomes at our center.

Methods

It is a retrospective, cross-sectional study from a single tertiary centre on 50 post renal transplant recipients aged 18years at transplantation from 2011 to 2025 (living–related and deceased donor). Data was collected from medical records and analysed. Continuous variables summarised at mean±SD. Group comparisons used T-test/ANOVA or Mann-Whitney/Fisher’s exact as appropriate

Results

Recipient age group – 11- 14 years -14(28%) and 15-18years- 36(72%). Recipient sex distribution- male-37 (74%) & female-13 (26%). Donor sex distribution – male – 17(34%), female- 33(66%). Donor relationship – father -14(28%), mother- 30(60%)&Cadaver-6(12%). Induction- not given – 31(62%), Basiliximab-12(24%), ATG- 7(14%). 2374.2%) out of 31 with no induction had rejection – 11(35.48%)- Chronic AMBR, 6(19.4%)- Acute ABMR &6(19.4) – ACR. CNI toxicity – 26%, rejection – 46% and recurrence – 10%. Mean time from transplant to Acute CNI toxicity – 0.88months, Chronic CNI toxicity- 58.33months, tacrolimus induced TMA –0 months, Acute ABMR – 25.33months, Chronic ABMR- 53.77months, ACR-36.17months, recurrence of FSGS-26months, IGAN – 92.67months and oxalosis- 7months. CMV infection – 6 (12%). PTDM – 10(20%). Alive recipients – 34-68%, alive recipients with failing graft – 10(20%), expired -6(12%). Mean duration of graft failure – 63.45months, death – 69.33months. CNI toxicity – mean tacrolimus level – 13ng/ml, infections – 8.77ng/ml and Rejection – 3.22ng/ml.

Conclusion

This study outlines post-transplant complications in pediatric recipients, emphasizing the absence of induction increased rejection rate and careful CNI monitoring to prevent toxicity and infections.

Kewords