Timing of peritoneal dialysis catheter removal after pediatric renal transplantation.

BACKGROUND

A peritoneal dialysis (PD) catheter is in place at the time of kidney transplantation in children receiving PD. Removal of the catheter eliminates the risk of catheter-related infections. However, the patient benefits from leaving the catheter in place if dialysis is necessary posttransplantation. There is currently no consensus on the proper timing of PD catheter removal after kidney transplantation in children.

OBJECTIVE

To identify the risks and benefits of an in-dwelling PD catheter after renal transplantation in children.

DESIGN

Retrospective single-center study of infectious complications and posttransplantation PD catheter use in 31 renal transplantations in 26 children.

RESULTS

Peritoneal dialysis catheters were used postoperatively in 13 of the 31 transplantations. In 12 instances the catheter was needed during the first month after transplantation, and 2 of the patients involved did not have a catheter in place when needed. Six catheter-related infections occurred in 5 patients posttransplantation, with only 1 infection taking place within 1 month after transplantation.

CONCLUSION

Our data suggest that the need for catheter use occurs predominantly during the first month, while infectious complications usually happen later. This strongly suggests that PD catheters should not be removed until approximately 1 month after kidney transplantation.