Tacrolimus in pediatric renal transplantation.

摘要: Tacrolimus was used as the primary immunosuppressive agent in 69 pediatric renal transplantations between December 17, 1989, and June 30, 1995. Children undergoing concomitant or prior liver and/or intestinal transplantation were excluded from analysis. The mean recipient age 10.3±5.0 years (range, 0.7-17.5 years). Seventeen (24.6%) children retransplantation, six (8.7%) had a panel reactive antibody level of 40% higher. Thirty-nine (57%) cases with cadaveric kidneys, 30 (43%) living donors. donor 28.0±14.7 1.0-50.0 years), cold ischemia time for kidneys 27.0±9.4 hr. antigen match 2.7±1.2, mismatch 3.1±1.2. All patients received tacrolimus steroids, without induction, 26% azathioprine well. follow-up 32±20 months. One- 4-year actuarial patient survival rates 100% 95%. graft 99% 85%. serum creatinine 1.2±0.8 mg/dl, calculated clearance 82±26 ml/min/1.73 m 2 . dose 0.22±0.14 mg/kg/day, 9.5±4.8 ng/ml. prednisone 2.1±4.9 mg/day (0.07±0.17 mg/kg/day), 73% successfully transplanted off prednisone. Seventy-nine percent not taking any antihypertensive medications. cholesterol 158±54 mg/dl. incidence delayed function 4.3%. rejection 49%, steroid-resistant 6%. decreased to 27% most recent 26 (January 1994 through 1995). new-onset diabetes 10.1%; seven affected able be weaned insulin. cytomegalovirus disease 13%, that posttransplant lymphoproliferative disorder 10%; last 40 transplants 5% (two cases). who developed are alive have functioning allografts. Based on this data, we believe is superior transplant patients, excellent short- medium-term survival, an ability withdraw steroids majority and, more experience, decreasing rate viral complications.