Long-term follow-up of renal transplantation in children Dr. Mash Naghibi, Dr. Fatemeh Nazemian Children develop end stage renal disease (ESRD) at an annual rate of 0.5 to 5.5/million population. A successful kidney transplant remains the most effective renal replacement therapy for children with ESRD. This study is carried out to evaluate kidney transplantation in children. We have reviewed 41 allografts performed in 41 children (age less than 16 years in the time of transplantation) between 1992 and 2002 in the Imam-Reza hospital. The patients were followed up for a duration of 18 months to 140 months. Recipients received triple immunosuppression therapy and limited-use antilymphocyte induction therapy. Rejection episodes were treated with IV pulse doses of methylprednisolone. In the case of steroid resistant rejection, the patients were given antilymphocyte globuline. Twenty one patients were male and twenty patients were female. The mean age of recipients were 13.5 years (ranging from 9 to 16). All of the donors were living donors. 39% of donors were living–related donors. Graft survival was 93%, 83% and 71% at 1, 3 and 5 years, respectively. Patient survival was 98%, 95% and 95% at 1, 3 and 5 years, respectively. The causes of graft lost were acute rejection (5) and chronic rejection (7). Hypertension was a frequent complication, since 36.6% patients with a 5-year follow-up were still being treated with antihypertensive drugs. 26 urinary tract infections were reported in 16 of 41 patients and E.coli is the most common cause of UTI. There was no malignancy in this series. In conclusion, graft survival in patients less than 16 years old is satisfactory and chronic rejection remains major cause of graft loss. Since successful renal transplantation offers the best chance for normal growth and quality of life, an early transplant should be considered.