Background and objective: Kidney transplantation
(KT) is the best modality treatment in children with
end-stage renal disease. Our center has performed KT
mostly from deceased donors due to short waiting
time. The induction therapy by interleukin 2 receptor
antagonist (IL2-RA) was limited use due to financial
issue. Therefore, this study aimed to report our experience
in pediatric deceased donor KT with restricted
use of induction therapy.
Methods: This retrospective descriptive study, review
the results of KT over 10 years. Medical records of all
pediatric KT recipients who were transplanted from
2003 to 2014 were reviewed. All patients received the
same maintenance immunosuppressive drugs except
the induction therapy by IL2-RA. We also reviewed
the results of KT between two groups in a different
period.
Results: Forty-eight pediatric KT recipients were
included in this study. The mean age of the recipients
was 12.8 years and the mean age of the deceased
donor was 30.3 years. All recipients were nonsensitized
patients and compatible crossmatch.
Fourteen patients (29%) received induction therapy
with IL2-RA and methylprednisolone, the rest received
only methylprednisolone (non-induction group). The
rate of rejection and infection between the induction
and non-induction groups did not differ significantly.
The graft survival rates at 1, 3, and 5 years after KT
were 93.7%, 83.9%, and 74.8%, respectively. The graft survival rates between induction and non-induction
groups were not significantly different. The mortality
rate of this study was 16.7%.
Conclusion: The standard-risk pediatric deceased
donor kidney transplantation in limited resources for
induction therapy had satisfying results. However, the
future study requires a greater data to support this
outcome