Kidney Transplantation in Small Children: Association Between Body Weight and Outcome—A Report From the ESPN/ERA-EDTA Registry. Issue 3 (March 2022)
- Record Type:
- Journal Article
- Title:
- Kidney Transplantation in Small Children: Association Between Body Weight and Outcome—A Report From the ESPN/ERA-EDTA Registry. Issue 3 (March 2022)
- Main Title:
- Kidney Transplantation in Small Children
- Authors:
- Boehm, Michael
Bonthuis, Marjolein
Aufricht, Christoph
Battelino, Nina
Bjerre, Anna
Edvardsson, Vidar O.
Herthelius, Maria
Hubmann, Holger
Jahnukainen, Timo
de Jong, Huib
Laube, Guido F.
Mattozzi, Francesca
Molchanova, Elena A.
Muñoz, Marina
Noyan, Aytul
Pape, Lars
Printza, Nikoleta
Reusz, George
Roussey, Gwenaelle
Rubik, Jacek
Spasojevic'-Dimitrijeva, Brankica
Seeman, Tomas
Ware, Nicholas
Vidal, Enrico
Harambat, Jérôme
Jager, Kitty J.
Groothoff, Jaap - Abstract:
- Abstract : Background: Many centers accept a minimum body weight of 10 kg as threshold for kidney transplantation (Tx) in children. As solid evidence for clinical outcomes in multinational studies is lacking, we evaluated practices and outcomes in European children weighing below 10 kg at Tx. Methods: Data were obtained from the European Society of Paediatric Nephrology/European Renal Association and European Dialysis and Transplant Association Registry on all children who started kidney replacement therapy at <2.5 y of age and received a Tx between 2000 and 2016. Weight at Tx was categorized (<10 versus ≥10 kg) and Cox regression analysis was used to evaluate its association with graft survival. Results: One hundred of the 601 children received a Tx below a weight of 10 kg during the study period. Primary renal disease groups were equal, but Tx <10 kg patients had lower pre-Tx weight gain per year (0.2 versus 2.1 kg; P < 0.001) and had a higher preemptive Tx rate (23% versus 7%; P < 0.001). No differences were found for posttransplant estimated glomerular filtration rates trajectories ( P = 0.23). The graft failure risk was higher in Tx <10 kg patients at 1 y (graft survival: 90% versus 95%; hazard ratio, 3.84; 95% confidence interval, 1.24-11.84), but not at 5 y (hazard ratio, 1.71; 95% confidence interval, 0.68-4.30). Conclusions: Despite a lower 1-y graft survival rate, graft function, and survival at 5 y were identical in Tx <10 kg patients when compared with Tx ≥10Abstract : Background: Many centers accept a minimum body weight of 10 kg as threshold for kidney transplantation (Tx) in children. As solid evidence for clinical outcomes in multinational studies is lacking, we evaluated practices and outcomes in European children weighing below 10 kg at Tx. Methods: Data were obtained from the European Society of Paediatric Nephrology/European Renal Association and European Dialysis and Transplant Association Registry on all children who started kidney replacement therapy at <2.5 y of age and received a Tx between 2000 and 2016. Weight at Tx was categorized (<10 versus ≥10 kg) and Cox regression analysis was used to evaluate its association with graft survival. Results: One hundred of the 601 children received a Tx below a weight of 10 kg during the study period. Primary renal disease groups were equal, but Tx <10 kg patients had lower pre-Tx weight gain per year (0.2 versus 2.1 kg; P < 0.001) and had a higher preemptive Tx rate (23% versus 7%; P < 0.001). No differences were found for posttransplant estimated glomerular filtration rates trajectories ( P = 0.23). The graft failure risk was higher in Tx <10 kg patients at 1 y (graft survival: 90% versus 95%; hazard ratio, 3.84; 95% confidence interval, 1.24-11.84), but not at 5 y (hazard ratio, 1.71; 95% confidence interval, 0.68-4.30). Conclusions: Despite a lower 1-y graft survival rate, graft function, and survival at 5 y were identical in Tx <10 kg patients when compared with Tx ≥10 kg patients. Our results suggest that early transplantation should be offered to a carefully selected group of patients weighing <10 kg. … (more)
- Is Part Of:
- Transplantation. Volume 106:Issue 3(2022)
- Journal:
- Transplantation
- Issue:
- Volume 106:Issue 3(2022)
- Issue Display:
- Volume 106, Issue 3 (2022)
- Year:
- 2022
- Volume:
- 106
- Issue:
- 3
- Issue Sort Value:
- 2022-0106-0003-0000
- Page Start:
- Page End:
- Publication Date:
- 2022-03
- Subjects:
- Transplantation of organs, tissues, etc -- Periodicals
Transplantation immunology -- Periodicals
617.95 - Journal URLs:
- http://journals.lww.com/pages/default.aspx ↗
- DOI:
- 10.1097/TP.0000000000003771 ↗
- Languages:
- English
- ISSNs:
- 0041-1337
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 9024.990000
British Library DSC - BLDSS-3PM
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- 26794.xml