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Children who receive a donated kidney from a living relative may be more likely to have a successful graft than those who receive the organ from a cadaver. A review of data on 1,667 kidney transplants from 73 pediatric transplantation centers in the US and Canada between 1987 and 1990 found that the most common causes of kidney failure requiring a transplant in children were congenital malformations of the kidneys and urinary tract and focal glomerulosclerosis. One year after transplantation, graft survival was 89% in the children who received a relative's kidney compared to 74% in those who received a cadaver's kidney. At three years, graft survival was 80% in children who received a relative's kidney and 62% in those who received a cadaver's kidney. At the time of the transplant, all the children were below the standard height for their age, and only the children younger than five years of age grew substantially after the transplant. Seventy-nine children died after receiving the transplant, and almost half died from infection.

Byline: Noosha Baqi (1), Anup Singh (1), Shivaiha Balachandra (1), Hadi Ahmad (1), Anthony Nicastri (1), Steve Kytinski (1), Peter Homel (1), Amir Tejani (1) Keywords: Key words:aAdolescent; Nephrotic syndrome; Focal segmental glomerulosclerosis Abstract: Data are sparse regarding the histological lesions associated with the primary nephrotic syndrome in adolescents. To our knowledge there are only two published articles that have specifically addressed the histopathological lesions that typify idiopathic nephrotic syndrome in the adolescent population. We reviewed our experience from the last 14 years of children between the ages of 12 and 18 years who were referred to our center for the evaluation of the nephrotic syndrome. A total of 29 adolescents met the inclusion criteria for this review. All patients were biopsied prior to the initiation of treatment. The sex ratio consisted of 52% males and 48% females and the racial breakdown was largely African-American, with 83% black adolescents, 7% Hispanic, and 10% Caucasian patients. Minimal change nephrotic syndrome (MCNS), the predominant lesion of children at an early age, was noted in only 20% of patients. The majority of patients (55.2%) had focal segmental glomerulosclerosis (FSGS) 7% had IgM nephropathy and 3.5% had diffuse mesangial hypercellularity. Only 7% of biopsied adolescents had membranoproliferative glomerulonephritis. Our results indicate that the most common lesion in this predominantly African-American patient population is FSGS, with only a small number showing MCNS. Thus, in our experience derived from a racially mixed population, adolescents with the nephrotic syndrome are less likely to have MCNS than younger children. Author Affiliation: (1) Division of Pediatric Nephrology, State University of New York HSC at Brooklyn, Brooklyn, New York, USA, US Article note: Received April 24, 1997 received in revised form September 2, 1997 accepted September 3, 1997