Jiménez DA, Holm CA, Hernández DM, Camarena AA

Language: Spanish
References: 10
Page: 129-132
PDF size: 47.66 Kb.

ABSTRACT

Objective: To assess the benefits and disadvantages offered by the intra-abdominal technique as compared to the extraperitoneal approach of renal graft implant in patients under 20 kg of weight.
Setting: Third level health care hospital.
Design: Retrospective, observational, clinical study.
Patients and methods: Study subjects were those renal transplant recipients with a weight equal or below 20 kg in the period between January 1st, 1995 and June 30, 1999. We reviewed the clinical records, analyzing the following variables: graft origin, ischemia time, preservation solution, conditions of the receptor, first or re-transplantation, and follow-up to the present time.
Results: Three-hundred transplants were performed, of which 35 (11%) corresponded to patients with a weight equal or below 20 kg, corresponding to the studied group. Gender ratio (M:F) was 1:1.9, average age 7.6 years. Kidneys were obtained from living donors in 18 cases and from cadavers in 17. Average weight of the recipient was 17.1 kg. Average hospital stay was 15.5 days. In 14 (40%), the extraperitoneal technique (group A) was used and in 21 (60%) the intraperitoneal one (group B). Nephrectomy was performed in six patients (17%), four (28%) of Group A and two (9%) of group B. Rejection occurred in nine patients (26%), six (43%) of group A and three (13%) of group B. No differences existed in the rest of the variables, and seric creatinine values at the time of hospital release were of 0.8 mg/dl for both groups.
Conclusion: According to our experience, the intraperitoneal implant technique offers better results than the extraperitoneal one for patients of less than 20 kg of weight, since the abdominal cavity allows the kidney to continue growing without vascular compromise, especially during the rejection episodes in which an increase in volume occurs.

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