Clinical Outcomes of Pediatric Renal Transplantation

Introduction: Renal transplantation offers the best treatment for a child with end-stage renal disease (ESRD). Aims: This study aims to evaluate the clinical outcomes of pediatric kidney transplants. Design: Retrospective and prospective observational study. Materials and Methods: Data of all patients with ESRD below 18 years of age, who underwent renal transplantation at our center from December 2015 to August 2024 were collected and analyzed. Results: Forty-six children were included in the study; 59% were males. There were 17 children below 10 years of age. The mean follow-up period was 55 months (range 2–104 months). The youngest child was 1 year 8 months and weighed 7.8 kg. Six children weighed < 10 kg at the time of surgery, and 10 children between 10 and 20 kg. Congenital anomaly of the kidney and urinary tract (CAKUT) (48%) and chronic glomerulonephritis (34%) were the most common native diseases. All children received triple immunosuppression with tacrolimus, mycophenolate mofetil, and prednisolone. Six children had graft loss during the follow-up period (104 months) and are back on dialysis. Graft survival was 94% at 1 year and 3 years and 86% at the end of 5 years; patient survival was 98% at 1 year, 3 years, and 5 years. We noted an increase in height and weight and good scholastic performance in all children with a functioning graft. Conclusions: CAKUT and glomerulonephritis are the most common causes of ESRD in children. Graft survival was 86%, and patient survival 98% at the end of 9 years.