Kidney transplant practice patterns and outcome benchmarks over 30 years: The 2018 report of the NAPRTCS

Abstract

The NAPRTCS has collected clinical information on children undergoing renal transplantation since 1987 and now includes information on 12 920 renal transplants in 11 870 patients. Since the first data analysis in 1989, NAPRTCS reports have documented marked improvements in patient and allograft outcomes after pediatric renal transplantation in addition to identifying factors associated with both favorable and poor outcomes. The registry has served to document and influence practice patterns, clinical outcomes, and changing trends in renal transplantation and also provides historical perspective. This report highlights current practices in an era of major changes in DD kidney allocation and continuing steroid minimization. This report presents outcomes of the patients in the NAPRTCS transplant registry up to end of 2017. In particular, an increase in the cumulative incidence of late first AR has occurred in the most recent cohort, while all prior cohorts had a lower cumulative incidence of late first AR.

Nocturnal hypertension and left ventricular hypertrophy in pediatric renal transplant recipients in South India

“…The prevalence of hypertension diagnosed by clinic BP in our cohort was similar to that reported by NAPRTCS 29 . However, we found a higher prevalence of masked HTN than prior studies.…”

“… Clinic BP ÷ 95th percentile of normative data or mean ambulatory BP ÷ 95th percentile of normative data for ABPM 28,29 …”

“… Ambulatory BP index: Mean ambulatory SBP/DBP value ÷ 95th percentile of SBP/DBP from normative data 29 …”

Current practice of antithrombotic prophylaxis in pediatric kidney transplantation—Results of an international survey on behalf of the European Society for Paediatric Nephrology

“…1 Although transplant survival rates have markedly improved over the last decades, renal graft thrombosis (RGT) remains a significant cause of early graft loss in pediatric kidney transplantation (KTx). 2 Renal graft thrombosis occurs mostly within the first week following KTx. 3 The reported incidence of RGT varies between 2.3% and 5.1%, mainly due to differences in study populations and associated risk factors.…”

“…3 The reported incidence of RGT varies between 2.3% and 5.1%, mainly due to differences in study populations and associated risk factors. 2,4 The available evidence does not allow a quantitative differentiation of RGT into arterial or venous thromboses. 5,6 The risk for developing a thrombotic episode due to modifiable and non-modifiable risk factors seems to be higher in pediatric than in adult renal transplantation.…”