Long-term outcomes in pediatric renal transplant recipients who survive into adulthood

Abstract

Background: Long-term results in renal transplant recipients who underwent transplantation as children are often buried within the outcomes of adult centers, leaving a void in our knowledge regarding this unique cohort. The authors aim to describe the long-term outcomes of children who experienced renal failure and subsequently underwent transplantation during childhood and who have now reached adulthood, with an emphasis on social and economic rehabilitation.

Methods: Two hundred seventeen children were identified who underwent transplantation between 1967 and 1999. Of those 217174 who were born before October 1982 and who would therefore have reached adulthood were selected for study. A questionnaire and consent form were sent to the surviving 132 patients of this subpopulation.

Results: Fifty-seven adult survivors answered the questionnaire. No significant differences were found comparing the respondents to the nonrespondents. Nearly half of all respondents were severely short and 27% were obese. Questionnaire respondents had high rates of hypertension, bone and joint symptoms, fractures, hypercholesterolemia, and cataracts. Despite significant remaining health issues, 82% of respondents were employed, 95% reported their health as "fair" or "good," 61% reported "no" or "minor" physical limitations, and 82% described themselves as "just as" or "more content than others." Nearly 50% of the respondents were married, and the overwhelming majority reported satisfaction in their sexual lives.

Conclusions: Despite a high retransplantation rate and the presence of significant morbidity, renal transplantation in children can lead to attainment of a productive and satisfying life, with a high degree of rehabilitation in adulthood.