Pediatric renal transplantation: A single Belgian center experience over 20 years

Between 1980 and 2000, 100 renal transplantations were performed in 91 chil dren at the pediatric unit of the University Hospital Leuven. The proportio n or living-related donors (LRD) was 20%. Patient survival rates were 94% a t 3 yr, 91% at 5 yr, and 87% at 10 yr. The commonest causes of death were b acterial infections and cardiovascular complications, which underscores the need for aggressive preventative procedures in this area after transplanta tion. The overall actuarial graft survival was 82% at 3 yr (n = 73), 74% at 5 yr (n = 53), and 56% at 10 yr (n = 29). In the LRD group. the graft surv ival was 10% better than the overall actuarial graft survival rate, The ove rall incidence of acute rejection was 55% but has shown a decrease to 34% i n more recent years (1993-99). The major causes of graft failure were chron ic rejection and recurrence of the initial disease, and these remain a majo r concern. Improvement of these results could be achieved by tight immunosu ppression management, early aggressive treatment of infection and rejection , and careful educational and psychological support.