Renal complications following heart transplantation in children:: A single-center study

Renal dysfunction is common following heart transplantation (Tx) in adults, but little is known in children. Thus, a retrospective chart review was performed in children who underwent heart Tx at the Hospital for Sick Children between April 1994 and April 1999. The inclusion criteria were: age <18years, survival >1 year post-Tx. The Schwartz formula was used to calculate glomerular filtration rate (GFR). Decreased GFR was defined as <80mL/min/1.73 m(2). Changes in GFR were analyzed using Repeated Measures Analysis of Variance. Forty-one eligible children were included. The mean age at Tx was 7 years (range: 1 month to 16.7 years). The mean F/UP was 33 +/- 17months, with 32/41 patients followed for at least 24months. The GFR was decreased in 42% pre-Tx, and in 7.3% at the last F/UP (p = 0.0001). GFR did not decline significantly with time after Tx; in fact, GFR increased in the first year and remained stable afterwards (p = 0.0002). Acute renal dysfunction (ARD) episodes were common (12/41 children). Hypertension was diagnosed in 76% of children during the first year post-Tx, but persisted in only 11 (27%). GFR improves in the majority of children following heart Tx. ARD episodes are frequent in the post-Tx period. Hypertension is common but does not persist.