Abstract
We evaluated the linear growth, mental development and changes in social behavior in pediatric renal allograft recipients who underwent transplantation between 1983 and 1986, and weve treated with ciclosporin A.
The individual post transplant growth rates before and one year after transplant were compared according to developmental stage. Linear growth of patients in the pre-pubertal group approached higher centile line, but in the pubertal group, the growth curves declined.
Changes in SDS (standard deviation score) were -3.19±1.53 to -2.80±1.58, -2.17±0.85 to -2.64±1.04, and -0.86±0.68 to -1.17±0.57 in prepubertal, prepubertal-pubertal, and pubertal groups, respectively.
GVI (growth velocity index) was 123.4±30.2, 82.9±39.5 and 46.4±25.3% in prepubertal and prepubertal-puberttal groups and patients on long term hemodialysis, respectively.
Although use of ciclosporin reduced the total corticosteroid dosage by about one half compared with conventional immunosuppressive therapy, to achieve satisfactory growth, transplantation should be done before the pubertal stage.
Changes in school attendance were also studied. Poor school attendance is one of the problems of children on hemodialysis and they miss class 4.3 hours per week. After transplantation, they miss class only 1.5 hours per week.
We also evaluated changes in character using the Yatabe-Guilford character test. Patients on hemodialysis tend to be average types and director types. After transplant, an increase in the black list type was noticed, and some were AE or AB types.
Careful attention, understanding and proper support are required in dealing with the emotional problems that may arise in the child.
