Paediatric renal transplantation in Northern Ireland (1984-1998)

Over the last 20 years a comprehensive paediatric nephrology service has be en developed in Northern Ireland, based in the academic medical unit at the Royal Belfast Hospital for Sick Children (RBHSC). In the 15 years 1984-199 8 a total of 77 renal transplants have taken place in patients aged 18 year s and under. Initially transplants were only considered in children over fi ve years of age but in the past eight years children as young as two years have successfully received kidneys. Aggressive nutritional support combined with peritoneal dialysis has enabled survival to a size when transplantati on is feasible. The 5 year graft survival was 64%, with two children dying following transplantation. The complexity of managing this age group is ref lected by the fact that a total of 10 transplants (13%) failed in the first 30 days. These figures compare favourably with statistics reported by simi lar paediatric centres from across the United Kingdom and Republic of Irela nd, and with local results in adult patients. This demonstrates that a succ essful end stage renal replacement programme for children is achievable in a relatively small population, which is geographically isolated.