1.Mismatched bone marrow transplantation for severe aplastic anaemia after liver transplantation for associated acute liver failure.
Vidyadhar P MALI ; Poh Lin TAN ; Marion AW ; Lincoln D S K LOH ; Seng Hock QUAK ; Krishnakumar MADHAVAN ; Prabhakaran KRISHNAN
Annals of the Academy of Medicine, Singapore 2011;40(9):420-421
2.Nineteen-year experience of paediatric renal transplantation in Singapore.
Kar Hui NG ; Pramod SHRESTHA ; Eric ARAGON ; Yew Weng LAU ; Wee Song YEO ; Yiong Huak CHAN ; Prabhakaran KRISHNAN ; Hui Kim YAP
Annals of the Academy of Medicine, Singapore 2009;38(4):300-309
INTRODUCTIONRenal transplantation is the treatment of choice for children with end-stage renal failure (ESRF). The paediatric renal transplant programme in Singapore was initiated in 1989. This study aimed to examine our outcomes over the 19-year period from 1989 to 2007.
MATERIALS AND METHODSA total of 38 renal transplants were performed at our centre. Another 4 patients with overseas transplants who returned within 3 weeks post-transplant were included. The proportion of living donor (LD) transplants was 61.9%. Structural abnormalities and glomerulopathies were the most common aetiologies comprising 33% each. Median age at transplant was 13.9 years and median waiting time was 2.2 years. LD transplant recipients were younger and had a shorter waiting time than deceased donor (DD) recipients.
RESULTSOverall patient survival rates were 95%, 92%, 86% and 86% at 1, 5, 10 and 15 years, respectively. There were 4 deaths, of which 3 were due to infections. Graft survival rates at 1, 5, 10 and 15 years for LD and DD transplants were 100%, 89.5%, 67.3%, 67.3% and 80.8%, 56.5%, 42.2%, 28.3% respectively, and were significantly higher in LD transplants. The main cause of graft loss was rejection following non-adherence. Multivariate analysis showed male gender, late acute rejections and acute tubular necrosis as predictors of graft failure. There was a high incidence of early bacterial infections (42.9%) and cytomegalovirus disease (16.7%).
CONCLUSIONOur graft survival rates for LD transplants were comparable to North American rates, although our DD transplant rates were slightly worse, probably a reflection of the prevailing transplant policies.
Adolescent ; Child ; Child, Preschool ; Female ; Graft Survival ; Humans ; Kidney Failure, Chronic ; surgery ; Kidney Transplantation ; utilization ; Living Donors ; supply & distribution ; Male ; Multivariate Analysis ; Outcome Assessment (Health Care) ; trends ; Postoperative Complications ; epidemiology ; Singapore ; epidemiology ; Survival Analysis ; Young Adult
3.Optimising utilisation of kidneys from very young deceased donors: the technique of en bloc kidney transplantation.
Ziting WANG ; Hui Kim YAP ; Krishnan PRABHAKARAN ; Ho Yee TIONG
Singapore medical journal 2015;56(8):e137-8
Kidneys of paediatric deceased donors were previously considered suboptimal for older recipients. An 18-month-old deceased donor was made available via Singapore's Medical (Therapy, Education and Research) Act. To the best of our knowledge, she is the youngest local donor. We herein report a case of successful kidney transplantation, using the en bloc technique, to a 15-year-old girl with renal failure secondary to bilateral cystic dysplastic kidney.
Adolescent
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Age Factors
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Female
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Humans
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Infant
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Kidney Diseases, Cystic
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surgery
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Kidney Transplantation
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methods
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Renal Insufficiency
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surgery
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Tissue Donors
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Tissue and Organ Procurement
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methods
Result Analysis
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