USE OF PROSTAGLANDIN IT IN 3 SMALL CHILDREN AT HIGH-RISK OF EARLY RENAL GRAFT THROMBOSIS

We report the use of prostaglandin I-2 (PGI(2)) in three small childre n weighing less than 15 kg at high risk of graft thrombosis after cada veric renal transplantation complicated by acute tubular necrosis. PGI (2) was started at a dose of 5 ng/kg per min within the first 6 h afte r transplantation, and was continued for 12-15 days. Before and during PGI(2) infusion, color-coded and pulsed Doppler sonography was perfor med. We found immediate restoration of diastolic flow, consistent with a decrease in vascular resistance. During the subsequent days, the so nographically assessed flow pattern and clinical graft function improv ed gradually. None of the three consecutively treated children develop ed graft thrombosis or lost his graft; no clinically relevant bleeding or adverse hemodynamic or pulmonary effects were seen.