Clinical problems encountered in renal homotransplantation in children

Renal homotransplantation has been performed in 15 children during the past four-and-one-half years. Living related donors were employed in 13 instances. One donor was a living, unrelated adopted parent, and one donor was a stillborn anencephalic monster. All recipients were in terminal stage of chronic renal failure. The early signs of impending rejection have differed considerably in this group of children from those reported for adults. Prompt recognition and appropriate therapy have successfully aborted all episodes of threatened rejection except for the one child not being followed in our center. The major clinical problems encountered include threatened rejection, postoperative hypertension and urinary tract infection. Fourteen children are living and leading an active and normal life with their transplanted kidneys functioning in a satisfactory manner. There have been no complications of the vascular anastomoses and none of the ureterovesical anastomoses. Growth appears to have been resumed at a normal rate.