Renal transplantation in children under 5 years of age

Between March 1987 and December 1997, 59 renal transplants [49 cadaveric, 1 0 live related (LRD)], were performed in 54 children aged 5 years and young er. Six children required a second transplant. The median (range) age of th e recipients was 2.9 (1.4-5.0) years; mean weight was 12.6 kg (7.4-23) and donor age 11 (2-50) years. Immunosuppression was cyclosporin or FK506. pred nisolone, and azathioprine. Antithymocyte globulin was given as induction t herapy for second transplants. Patient survival was 98.3%; 1 patient died f rom upper gastrointestinal haemorrhage. Graft survival was 67.7% at 1 year, 57.4% at 5 years, and 45.2% at 10 years. No LRD graft was lost during 7 ye ars of follow-up. Thrombosis was the main cause of graft loss (10 cases) fo llowed by vascular rejection (2 cases). There was no significant difference in graft survival between recipients aged less than 2, 2-3, and 3-5 years. The height standard deviation score (+/-SD) improved from -2.1+/-1.3 at tr ansplantation ;to -1.0+/-1.3 at 1 year, -1.1+/-1.5 at 5 years, and to -0.14 +/-1.1 at 10 years.