Cyclosporin A in paediatric kidney transplantation. 1987

G Offner, and P F Hoyer, and J Brodehl, and R Pichlmayr
Department of Paediatric Nephrology and Metabolic Diseases, Hannover Medical School, Federal Republic of Germany.

Cyclosporin A (CyA) is an immunosuppressive agent which has been used in children following kidney transplantation since 1982. The paediatric experience made with CyA in a single centre is reported here. Forty-seven children, ranging in age from 2 to 16 years, were given transplants between September 1982 and May 1986 and received CyA with low-dose prednisolone for immunosuppression. The mean cold ischaemia time of the grafts was 20.9 h. Under routine volume expansion during and 24 h posttransplantation, 40 grafts (85%) functioned immediately. Acute rejection episodes occurred with the highest frequency during the 1st month (0.6 rejection/patient). The actuarial survival rate for patients was 98% after 3 years. Graft survival was 92% after 1 year, 87% after 2 years and 78% after 3 years. The side-effects observed with CyA were hypertrichosis (38%), neurological complications (21%), and infections (17%). One girl of 16 years developed benign mammary fibroadenomas. Hypertension was common (60%), but less so than seen with conventional therapy (83%). Graft function was reduced. The mean creatinine clearance at 6 weeks after transplantation was 60 ml/min per 1.73 m2, after 1 year was 46.4 ml/min per 1.73 m2 and after 2 years it was 42.5 ml/min per 1.73 m2. Twenty-nine children with functioning grafts of at least 1 year could be evaluated for growth performance and normal or even catch-up growth could be demonstrated for the whole group. The individual annual growth rates expressed by standard deviation score (SDS) remained stable or even improved 3 years after kidney transplantation. Longer periods of follow-up are necessary to confirm whether the advantages concerning survival rates and growth rates persist over time and will outweigh the side-effects of CyA treatment.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007676 Kidney Failure, Chronic The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION. ESRD,End-Stage Renal Disease,Renal Disease, End-Stage,Renal Failure, Chronic,Renal Failure, End-Stage,Chronic Kidney Failure,End-Stage Kidney Disease,Chronic Renal Failure,Disease, End-Stage Kidney,Disease, End-Stage Renal,End Stage Kidney Disease,End Stage Renal Disease,End-Stage Renal Failure,Kidney Disease, End-Stage,Renal Disease, End Stage,Renal Failure, End Stage
D008297 Male Males
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003524 Cyclosporins A group of closely related cyclic undecapeptides from the fungi Trichoderma polysporum and Cylindocarpon lucidum. They have some antineoplastic and antifungal action and significant immunosuppressive effects. Cyclosporins have been proposed as adjuvants in tissue and organ transplantation to suppress graft rejection. Cyclosporines
D005260 Female Females
D006084 Graft Rejection An immune response with both cellular and humoral components, directed against an allogeneic transplant, whose tissue antigens are not compatible with those of the recipient. Transplant Rejection,Rejection, Transplant,Transplantation Rejection,Graft Rejections,Rejection, Graft,Rejection, Transplantation,Rejections, Graft,Rejections, Transplant,Rejections, Transplantation,Transplant Rejections,Transplantation Rejections
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths

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