Meza-Ocaña K, Medina-Vega FA. Maza-Vallejos J

Language: Spanish
References: 12
Page: 41-48
PDF size: 267.68 Kb.

ABSTRACT

Introduction. End stage renal disease (ESRD) leads, in pediatric patients, to growth delay and psychomotor retardation, electrolyte alterations, osteodistrophy, and occasionally death. Kidney transplantation is the ideal treatment because it fully improves the general conditions of the patient compared to dialysis therapy alone. In Mexico the culture of organ donation is not fully accepted,. This has caused the criteria for cadaveric donors to be expanded in order to meet the demand for transplants. Pediatric donor kidney transplantation from children less than 60 months to pediatric recipients is an increasingly popular option, The aim of this paper is to present the experience in 3 cases of patients who have received renal transplant en bloc from cadaveric donors, from 2005 to 2010.
Cases. Case 1. Male 16 years diagnosed with ESRD, hypertension and idiopathic myelofibrosis with 5% cellularity. Protocol hemodialysis for 3 years. En bloc kidney transplantation was performed from cadaveric donor. The age of the donor was 60 months. Case 2. Male 16 years diagnosed with ESRD without identified etiology. In hemodialysis for 1 year and 6 months. In bloc renal transplantation was performed from cadaveric donor. The age of the donor was 30 months. Case 3. Male 17 years old with a diagnosis of ESRD secondary to rapidly progressive glomerulopathy with tubulointerstitial damage, started peritoneal dialysis and hemodialysis. Renal transplantation was performed in bloc from a 24 months cadaveric donor. In all cases the vesicoureteral reimplantation was Lich-Gregoir.
Discussion. The increasing number of patients with ESRD that need a kidney transplant has lead to the expansion in inclusion criteria in order to include cadaveric donors under 60 months old as in bloc donors. In the last five years, 3 in bloc transplants from cadaveric donors under 60 months old to adolescent recipients have been performed. No complications have been reported during surgery or follow up. Image controls and scintigraphy were reported as normal. One acute rejection and another chronic one were reported.
Conclusion.Promising outcomes can be obtained from in bloc kidney transplantation from infant donors. The use of this donor population for pediatric recipients should be excellent resources that should be procured where available.

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