Continuing improvement in cadaver donor graft survival in North American children: the 1998 annual report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS)

Pediatr Transplant. 2000 Aug;4(3):235-46. doi: 10.1034/j.1399-3046.2000.00116.x.

Abstract

This report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) covers the years 1987-1997, and analyses data on 3,133 cadaver donor (CD) transplants performed in 2,736 patients. There has been a steady decline in the number of CD transplants in children since 1996. Kidneys recovered from donors under 10 years of age accounted for 35% of all transplants in 1987, whereas by 1996 they comprised less than 20%. Caucasian children received 54% of CD transplants, whereas African-American children received 21%. Children under 6 years of age received 17% of CD transplants. Approximately half (46%) of the patients were induced with a T-cell antibody, and at 7 years post-transplant triple therapy is used in 70% of those with a functioning graft. Cyclosporin A is the primary immunosuppressant, with 92% of the patients being maintained on it at 5 years post-transplant. Among patients receiving a transplant in 1997, 11% were initiated with another calcineurin inhibitor, tacrolimus. At 15 days post-transplant 20% of the patients have had a rejection episode and by day 45, 46% have had an acute rejection. The probability of developing a rejection within the first year was reduced from 71% in 1987-1988 to 47% in 1995-1996.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Cadaver
  • Child
  • Child Development
  • Child, Preschool
  • Continental Population Groups
  • Female
  • Graft Rejection / epidemiology
  • Graft Survival*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Infant
  • Kidney Transplantation / statistics & numerical data*
  • Kidney Transplantation / trends
  • Length of Stay / statistics & numerical data
  • Male
  • North America / epidemiology
  • Proportional Hazards Models
  • Registries
  • Survival Analysis

Substances

  • Immunosuppressive Agents