Child with transplanted kidney – difficult patient: peculiarities of medical observation, interaction with family

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Abstract


Relevance. Terminal chronic renal failure (CRF) in children is growing worldwide and is an important medical, social and economic problem. The fatality in early and distant terms in transplantation, is 13–15%. Kidney transplantation (Moscow, Samara) has been carried out in the territory of the Samara region since 2005. Kidney transplantation was carried out for 21 children, fatality was 9.5%.

Aim. Study the results of kidney transplantation in children with CRF, peculiarities of medical observation, commitment to treatment, interaction with the patient ‘s family.

Materials and methods. 21 children and a teenager with terminal CRF with kidney transplantation between the ages of 6 and 18.

Results. The main causes of terminal CRF formation in children with kidney transplantation were congenital (CAKUT syndrome) and hereditary diseases. The maximum survival time of the graft was 15 years. The main feature of medical support of patients with transplanted kidney was observation of immunosuppression and its correction. Most children get tacrolimus. Transplant rejection occurred in 1 child in case of disorder of drug administration. Another patient had acute transplant rejection, and the teenager died. After the kidney transplant, the patient’s life and surroundings change in a positive direction. 8 adult patients work after receiving higher education.

Conclusions. Kidney transplantation occupies a major place in the treatment of CRF in children. The necessary condition for transplant survival is long-term rehabilitation of the patient, commitment to observation and treatment, constant interaction with the child ‘s family.


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About the authors

Galina A. Makovetskaya

Samara State Medical University

Author for correspondence.
Email: gmakovetskaya@yandex.ru
ORCID iD: 0000-0003-3934-8699

Russian Federation, Samara

D. Sci. (Med.), Prof.

Olga V. Borisova

Samara State Medical University

Email: gmakovetskaya@yandex.ru
ORCID iD: 0000-0003-1430-6708

Russian Federation, Samara

D. Sci. (Med.), Prof.

Ilia V. Barinov

Samara State Medical University

Email: gmakovetskaya@yandex.ru

Russian Federation, Samara

Assistant

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Supplementary files

Supplementary Files Action
1.
Figure. The main reasons for the development of end-stage chronic renal failure in children with kidney transplant.

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