Quality of life after renal transplantation in childhood

The goal of renal transplantation is to achieve the best possible quality o f life in patients with terminal renal failure. To evaluate some aspects of quality of life in patients with renal grafts during childhood of our cent er, data on medical, educational and professional rehabilitation were colle cted retrospectively. Between 1972 and 1997 135 renal transplantations had been performed in 123 patients below the age of 18 years. 12-year graft sur vival of patients transplanted before 1983 figured at 21% and rose to 62% d uring the following years, after introduction of cyclosporine A into the im munosuppressive regimen. The proportion of patients in the respective age g roup attending a secondary school (16%) was lower and of those attending el ementary school (71%) or a school for disabled and handicapped children (11 %) was higher than usual in the German population. But, 83% of all patients reached a school degree. After school 78% proceeded with a vocational trai ning or university. 89% of patients completing professional training were e mployed at last observation as compared to only 60% of those who never fini shed a professional training. Renal replacement therapy starting already du ring the early phase of education is difficult to coordinate with normal sc hooling. Considering these health- and time-related obstacles, the degree o f educational and professional rehabilitation of the patients is good. But, there is a need for special support accompanying educational and professio nal training.