Paediatric Renal Retransplantation

Abstract

While the results of renal transplantation in adults and children have improved over the past decade, there still remains a cohort of patients in whom primary graft failure is inevitable. Early failure results not only from technical and surgical complications but immunological reasons still account for the persistent failure of grafts and an inevitable reduction in graft survival. While in adults the return to haemodialysis or peritoneal dialysis seems to offer a temporary solution, in the paediatric group, the continuation of these modalities of treatment does not offer a viable solution to children who require to grow and develop into near normal adolescent and adult life. The problem of failure has been compounded by the serious problem of non-compliance and even meticulous supervision does not resolve the dangers related in this select group of patients. Most transplant centres have a 15% retransplantation rate.