Overview of a paediatric renal transplant programme

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dc.contributor.authorMcCulloch, M
dc.contributor.authorGajjar, P
dc.contributor.authorSpearman, W
dc.contributor.authorBurger, H
dc.contributor.authorSinclair, P
dc.contributor.authorSavage, L
dc.contributor.authorMorrison, C
dc.contributor.authorDavies, C
dc.contributor.authorRuysch van Dugteren, GPA
dc.contributor.authorMaytham, D
dc.contributor.authorWiggelinkhuizen, J
dc.contributor.authorPascoe, M D
dc.contributor.authorMcCurdie, F J
dc.contributor.authorPontin, A
dc.contributor.authorMuller, E
dc.contributor.authorNumanoglu, A
dc.contributor.authorMillar, A J W
dc.contributor.authorRode, H
dc.contributor.authorKhan, D
dc.date.accessioned2017-06-30T06:52:07Z
dc.date.available2017-06-30T06:52:07Z
dc.date.issued2006
dc.date.updated2016-01-12T07:45:31Z
dc.description.abstractINTRODUCTION: Renal transplantation is the therapy of choice for children with end-stage renal failure. There are many challenges associated with a paediatric programme in a developing country where organs are limited. METHODS: A retrospective review was undertaken of 149 paediatric renal transplants performed between 1968 and 2006 with specific emphasis on transplants performed in the last 10 years. Survival of patients and grafts was analysed and specific problems related to drugs and infections were reviewed. RESULTS: On review of the total programme, 60% of the transplants have been performed in the last 10 years, with satisfactory overall patient and graft survival for the first 8 years post transplant. At this point, transfer to adult units with non-compliance becomes a significant problem. Rejection is less of a problem than previously but infection is now a bigger issue--specifically tuberculosis (TB), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infections with related complications. A wide variety of drugs are available for tailoring immunosuppression to minimise side-effects. CONCLUSION: It is possible to have a successful paediatric transplant programme in a developing country. However, to improve long-term outcomes certain issues need to be addressed, including reduction of nephrotoxic drugs and cardiovascular risk factors and providing successful adolescent to adult unit transition.
dc.identifierhttp://dx.doi.org/10.7196/SAMJ.1294
dc.identifier.apacitationMcCulloch, M., Gajjar, P., Spearman, W., Burger, H., Sinclair, P., Savage, L., ... Khan, D. (2006). Overview of a paediatric renal transplant programme. <i>South African Medical Journal</i>, http://hdl.handle.net/11427/24668en_ZA
dc.identifier.chicagocitationMcCulloch, M, P Gajjar, W Spearman, H Burger, P Sinclair, L Savage, C Morrison, et al "Overview of a paediatric renal transplant programme." <i>South African Medical Journal</i> (2006) http://hdl.handle.net/11427/24668en_ZA
dc.identifier.citationMcCulloch, M., Gajjar, P., Spearman, C., Burger, H., Sinclair, P., Savage, L., Morrison, C., Davies, C., van Dugteren, G., Maytham, D., Wiggelinkhuizen, J., Pascoe, M., McCurdie, F., Pontin, A., Muller, E., Numanoglu, A., Miller, A., Rode, H., & Kahn, D. (2006). Overview of a peadiatric renal transplant programme. South African Medical Journal, 96(9), 955.
dc.identifier.ris TY - Journal Article AU - McCulloch, M AU - Gajjar, P AU - Spearman, W AU - Burger, H AU - Sinclair, P AU - Savage, L AU - Morrison, C AU - Davies, C AU - Ruysch van Dugteren, GPA AU - Maytham, D AU - Wiggelinkhuizen, J AU - Pascoe, M D AU - McCurdie, F J AU - Pontin, A AU - Muller, E AU - Numanoglu, A AU - Millar, A J W AU - Rode, H AU - Khan, D AB - INTRODUCTION: Renal transplantation is the therapy of choice for children with end-stage renal failure. There are many challenges associated with a paediatric programme in a developing country where organs are limited. METHODS: A retrospective review was undertaken of 149 paediatric renal transplants performed between 1968 and 2006 with specific emphasis on transplants performed in the last 10 years. Survival of patients and grafts was analysed and specific problems related to drugs and infections were reviewed. RESULTS: On review of the total programme, 60% of the transplants have been performed in the last 10 years, with satisfactory overall patient and graft survival for the first 8 years post transplant. At this point, transfer to adult units with non-compliance becomes a significant problem. Rejection is less of a problem than previously but infection is now a bigger issue--specifically tuberculosis (TB), cytomegalovirus (CMV) and Epstein-Barr virus (EBV) infections with related complications. A wide variety of drugs are available for tailoring immunosuppression to minimise side-effects. CONCLUSION: It is possible to have a successful paediatric transplant programme in a developing country. However, to improve long-term outcomes certain issues need to be addressed, including reduction of nephrotoxic drugs and cardiovascular risk factors and providing successful adolescent to adult unit transition. DA - 2006 DB - OpenUCT DP - University of Cape Town J1 - South African Medical Journal LK - https://open.uct.ac.za PB - University of Cape Town PY - 2006 T1 - Overview of a paediatric renal transplant programme TI - Overview of a paediatric renal transplant programme UR - http://hdl.handle.net/11427/24668 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/24668
dc.identifier.vancouvercitationMcCulloch M, Gajjar P, Spearman W, Burger H, Sinclair P, Savage L, et al. Overview of a paediatric renal transplant programme. South African Medical Journal. 2006; http://hdl.handle.net/11427/24668.en_ZA
dc.language.isoeng
dc.publisher.departmentDivision of Child and Adolescent Psychiatryen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.sourceSouth African Medical Journal
dc.source.urihttp://www.samj.org.za/index.php/samj
dc.titleOverview of a paediatric renal transplant programme
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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