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ABSTRACT: To assess patient survival in pediatric renal transplantation, we retrospectively reviewed 573 transplants in 553 patients, registered from 1995 to 2005.
Mean age at transplantation was 9.9 years. Patient survival at 1, 5 and 10 years was respectively 99%, 97% and 96%. Death occurred at a median time of 2.6 years after transplantation. Long-term patient survival was significantly lower in recipients younger than 5 years old. Seventeen patients (3.1%) died. Two deaths occurred while under maintenance dialysis. Among the remaining patients, the two main causes of death were infections (33%) and malignancies (27%). Interestingly, initial disease-related complications were a major cause of death (34%).
A low mortality rate was observed, with the majority of deaths due to malignancies and infections, and with a notable participation of complications related to the initial disease. No impact of cardiovascular disease was noted with the given follow-up period. Improvements in managing immunosuppression may contribute to reducing mortality in pediatric renal transplantation.
Pediatric Transplantation 10/2009; 13(6):725-30. · 1.48 Impact Factor
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Archives de Pédiatrie 07/2009; 16(6):940-2. · 0.30 Impact Factor
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Archives de Pédiatrie 07/2008; 15(5):879-80. · 0.30 Impact Factor
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G Roussey-Kesler,
V Gadjos,
N Idres,
B Horen,
L Ichay,
M D Leclair,
F Raymond,
A Grellier,
I Hazart,
L de Parscau,
R Salomon,
G Champion,
V Leroy,
V Guigonis,
D Siret,
J B Palcoux,
S Taque,
A Lemoigne,
J M Nguyen, C Guyot
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ABSTRACT: Antibiotic prophylaxis is given to children at risk for urinary tract infection. However, evidence concerning its effectiveness in grade I to III vesicoureteral reflux is lacking. The objective of this study was to determine whether antibiotic prophylaxis reduces the incidence of urinary tract infection in young children with low grade vesicoureteral reflux.
Children 1 month to 3 years old with grade I to III vesicoureteral reflux were assigned randomly to receive daily cotrimoxazole or no treatment, and followed for 18 months. A urinary tract infection constituted an exit criterion. Infection-free survival rates were calculated using the Kaplan-Meier method and compared using the log rank test.
A total of 225 children were enrolled in the study. Distribution of gender, age at inclusion and reflux grade were similar between the 2 groups. There was no significant difference in the occurrence of urinary tract infection between the 2 groups (17% vs 26%, p = 0.2). However, a significant association was found between treatment and patient gender (p = 0.017). Prophylaxis significantly reduced urinary tract infection in boys (p = 0.013), most notably in boys with grade III vesicoureteral reflux (p = 0.042).
These data suggest that antibiotic prophylaxis does not reduce the overall incidence of urinary tract infection in children with low grade vesicoureteral reflux. However, such a strategy may prevent further urinary tract infection in boys with grade III reflux.
The Journal of urology 03/2008; 179(2):674-9; discussion 679. · 4.02 Impact Factor
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ABSTRACT: Chronic renal failure has never been described after Puumala hantavirus infection, which usually causes acute renal failure with spontaneous full recovery. We report a 15-year-old boy who presented with Puumala hantavirus infection and initial severe acute renal failure. His renal function gradually improved, but more than 2 years after the acute episode it was still moderately impaired, with a creatinine clearance of about 60 ml/min per 1.73 m(2)
Pediatric Nephrology 12/1999; 13(9):934-5. · 2.52 Impact Factor
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S Cloarec,
G Deschênes,
M Besson-Leaud,
C Casenave,
C Gambert, C Guyot,
Y Hermouet,
P Romanet,
C Roy,
S Benoit,
H Nivet
Archives de Pédiatrie 01/1997; 3(12):1209-14. · 0.30 Impact Factor
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Transplantation Proceedings 03/1994; 26(1):97. · 1.00 Impact Factor
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C Guyot
Transplantation Proceedings 03/1994; 26(1):22. · 1.00 Impact Factor
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ABSTRACT: The results of a controlled therapeutic trial comparing 2 groups of patients presenting with hemolytic-uremic syndrome (HUS) are reported. Group A (15 children) was given urokinase (UK) and heparin; group B (18 children) received no treatment. Ages of patients, the delay before admission, the severity of anemia, thrombocytopenia and initial renal failure were similar in both groups. UK was responsible for bleedings in 12 children, minimal in 8, severe in 4. No child died in group A, 3 children died in group B (n.s.). Durations of hemolysis, thrombocytopenia and anuria were similar in both groups. Long-term evolutions of renal function and arterial pressure were comparable in both groups. Needle kidney biopsy (26 cases) showed cortical necrosis in 3 children of group A and in 2 of group B, and glomerular thrombotic microangiopathy in 10 children of group A and in 11 of group B. The average ratio of injured glomeruli was 40 (19 to 80) in group A, and 38 (21 to 75) in group B. Two children in group A and 3 children in group B presented with 50 to 80% of glomerular lesions. This trial suggests that UK is of no significant value in the treatment of HUS.
Archives françaises de pédiatrie 02/1984; 41(1):15-9.
