A comparison of post‐transplant renal function in pre‐emptive and post‐dialysis pediatric kidney transplant recipients. (8th February 2019)

• Record Type: Journal Article
• Authors: Kim, Jin K.; Lorenzo, Armando J.; Farhat, Walid A.; Chua, Michael E.; Ming, Jessica M.; Dos Santos, Joana; Koyle, Martin A.
• Is Part Of: Pediatric transplantation. Volume 23:Number 3(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-02-08
• Subjects: kidney transplantation -- pediatric -- post‐dialysis -- pre‐emptive -- renal function; Transplantation of organs, tissues, etc. in children -- Periodicals; 617.95408305
• DOI: 10.1111/petr.13377
• Languages: English
• ISSNs: 1397-3142

Abstract

Abstract: Purpose: Little is known regarding post‐transplant renal function following pediatric pre‐emptive KT. Therefore, this study aims to determine whether there is a difference in 1 year post‐transplant renal function outcomes between pre‐emptive and post‐dialysis KT in pediatric transplant recipients. Methods: A retrospective review of patients who underwent kidney transplant at our institution between 2000 and 2015 was performed. Kidney transplant recipients were divided into four groups: pre‐DD, post‐DD, pre‐LD, and post‐LD. The clinical outcomes, measured in eGFR (mL/min/1.73 m 2 ), acute rejection episodes within 1 year, and hospitalization within 1 year were compared to between groups in their respective donor types (pre‐DD vs post‐DD; pre‐LD vs post‐LD). Results: The 324 patients were identified (21 pre‐DD, 151 post‐DD, 54 pre‐LD, and 98 post‐LD). Post‐DD group had more females ( P = 0.018) and post‐operative complications ( P = 0.023), although there was no difference in complications requiring intervention ( P = 0.129). Post‐LD patients were more likely to be females ( P = 0.017) and those with intrinsic renal (non‐urological/structural) ESRD etiology ( P = 0.003). The 1‐year eGFR was similar between pre‐DD and post‐DD groups (70.3 [IQR 53.5‐88.5] vs 74.3 [IQR 62.3‐90.5], P = 0.613), as well as pre‐LD and post‐LD groups (66.6 [IQR 47.8‐73.7] vs 63.9 [IQR 55.0‐77.1], P = 0.600). There were no significant differences in rates of acute rejection episodes or hospitalization within 1 year of transplantation for in LD/DD groups. Conclusion: There is no significant difference in renal function at 1 year post‐transplant in pediatric patients receiving pre‐emptive or post‐dialysis kidney transplants.