الفهرس | Only 14 pages are availabe for public view |
Abstract This study was carried out on 153 renal transplants who received their grafts at or less than 17 years old in Mansoura Urology and Nephrology Center. These patients were evaluated regarding their patient and graft survival, the physical and sexual growth, the bone problems, the echocardiographic abnormalities and the neuromuscular changes. Our results showed that the graft and patient survival were comparable to many of the American and European survivals, the risk factors for graft failure by univariate analysis were the HLA matching, primary urinary recontinuity, time to diuresis, ATN, acute rejection and its type, and posttrans plant hypertension . But the multivariate Cox proportional hazards regression models restricted the significance to acute rejection and posttransplant hypertension. The significant risk factors for growth retardation were growth retardation at transplantation, immunosuppressive regimen, cumulative steroid dose/year and graft dysfunction. The significant risk factors for delayed puberty were female sex, growth retardation, cumulative steroid dose/year and renal dysfunction. Osteopenia and osteoprosis were documented in two thirds of 83 pediatric renal transplants, the risk factors for osteopenia and osteoporosis were usage of cyclosporine therapy, cumulative steroid dose per m2 surface area and graft dysfunction. The left ventricular hypertrophy was the commonest echocardiographic abnormality and its risk factors were the pretransplant dialysis, posttransplant hypertension, anemia and graft dysfunction. Early neuropathic changes may occur in pediatric renal transplant recipients and the strongest predictors for its occurrence are cumulative dose of steroids and graft dysfunction. |