Risk Factors for Short- and Long-term Survival of Primary Cadaveric Renal Allografts in Pediatric Recipients: A UNOS Analysis

Hwang, Andrew H.; Cho, Yong W.; Cicciarelli, J; Mentser, Mark; Iwaki, Yuichi; Hardy, Brian

doi:10.1097/01.tp.0000168090.19875.b0

Cited by 62 publications

(55 citation statements)

References 17 publications

(12 reference statements)

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“…Transplant survival was affected by age until the last decade of our study, with an increased graft loss in those transplanted before 2 years of age in the 1980s and 1990s. Age becomes important again at adolescence [9, 10, 23], when non-concordance contributes significantly to transplant loss [18, 23], an effect that we saw in our patients, although this did not reach statistical significance during the last decade.…”

Section: Discussionmentioning

confidence: 46%

“…UK transplant data [23] demonstrated an increased risk of early transplant loss, principally due to technical difficulties, in those <2 years of age, although after this time graft loss was equal to that of older children. More recent UNOS data [9] have shown that younger age and earlier era of transplant adversely affect transplant outcome and give an odds ratio of 2 for increased risk of graft loss in 2- to 5-year-olds in comparison with 6- to 12-year-old children. Transplant survival was affected by age until the last decade of our study, with an increased graft loss in those transplanted before 2 years of age in the 1980s and 1990s.…”

Section: Discussionmentioning

confidence: 99%

“…Papers describing long-term patient survival [2,3,4,5,6], transplant outcome [2, 3,6,7,8,9,10], and psychosocial adjustment [11, 12] are now emerging, enabling doctors to offer better prognostic advice and guidance to families. Although national registries are able to provide statistical predictions that are not possible from a single centre, more complete and detailed data are often available from individual units.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Long-Term Outcome of Paediatric Renal Transplantation: Follow-Up of 300 Children from 1973 to 2000

Rees¹,

Shroff²,

Hutchinson³

et al. 2006

Nephron Clin Pract

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Background/Aim: To report our experience of paediatric renal transplantation at Great Ormond Street and Royal Free Hospitals since the inception of the programme. Methods: Retrospective review of the patient and transplant survival and influencing factors in the 300 children transplanted between 1973 and 2000. Results: 300 children had received a total of 354 transplants; 56 were living-related donations. The median age at transplantation was 10.3 (range 1.4–17.9) years. Forty-four percent had congenital structural abnormalities of the urinary tract. Forty-six children required a second and 8 a third transplant before transfer to an adult unit. The overall patient survival at 5, 10, and 20 years was 97, 94, and 72%, respectively. In the overall cohort, the donor type (deceased donor or living-related donor) did not affect mortality, nor did age at transplantation, but those transplanted before 5 years of age had a significantly shorter post-transplant survival time (p < 0.0001). Transplant survival (first transplant) for deceased and living-related donors was 66 and 87% at 5 years (p < 0.01), 51 and 54% at 10 years, and 36% at 20 years (deceased-donor transplants only). Although the overall transplant survival was inferior in children transplanted before 2 years of age (p < 0.03), in the most recent cohort (1990–2000), age did not affect the outcome. On multiple regression analysis, the only predictor of transplant survival was the era of transplantation (p < 0.001). The median final height was within the normal range for males and females; 7 patients received growth hormone after transplantation. Conclusions: The outlook for successful transplantation is improving, and in the last decade was unaffected by age at transplantation. The survival of living-related donor transplants is superior to deceased-donor transplants for the first 5 years. From the above data, we can predict that a 10-year-old child receiving a renal transplant in 2000 and on ciclosporin-based immunosuppression can expect a transplant half-life of 13.1 years from a living-related donor and one of 10.8 years from a deceased-donor transplant.

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-Term Outcome of Paediatric Renal Transplantation: Follow-Up of 300 Children from 1973 to 2000

Rees¹,

Shroff²,

Hutchinson³

et al. 2006

Nephron Clin Pract

View full text Add to dashboard Cite

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“…Renal allograft survival in infants is now similar to that in older children [7,8], and short-term deceased donor allograft survival in children now approaches that of living donation [7,8]. Three-and five-year graft survival rates in children have been shown to be related to the transplant center, recipient race, recipient age, primary disease, date of transplant, panel reactivity (PRA), and donor source [5,9]. The half-life of renal allografts in pediatric patients is now about 10 years [10]; therefore, it is important to explore the factors related to long-term, greater than 10 year, allograft survival.…”

Section: Introductionmentioning

confidence: 96%

“…Renal allograft survival in children has improved substantially over the last two decades, with several large registry studies reporting graft survival approaching 80% at 3 years and 75% at 5 years [1][2][3][4][5]. A single center study reported 66% graft survival at 10 years [6].…”

Section: Introductionmentioning

confidence: 99%

Factors related to long-term renal transplant function in children

et al. 2008

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Short-term renal allograft survival in children has improved. It is therefore important to determine the factors leading to long-term graft function. To this end, we evaluated patients in the NAPTRCS registry who were <12 years old when they received their renal transplant between 1987 and 1993. Children with 10 years of post-transplant follow-up were compared to those in whom the transplant failed within 10 years. Children with a failed transplant within 10 years of the surgery tended to be older, female, and non-Caucasian; they also manifested obstructive uropathy less often and had focal segmental glomerulosclerosis more often, and they received more deceased donor kidneys. Children with a failed renal transplant had fewer HLA donor and recipient matches, received pre-transplant dialysis compared to a preemptive transplant, required dialysis in the first week post-transplant, and required more antihypertensives the first month post-transplant. Allograft function was examined at 10 years. Patients with continued allograft function and a serum creatinine

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