Improved Outcomes of Kidney Transplantation in Infants (Age < 2 years): A Single-Center Experience

Transplantation. 2018 Feb;102(2):284-290. doi: 10.1097/TP.0000000000001929.

Abstract

Background: Infants (age, < 2 years) with end-stage renal disease (ESRD) have increased morbidity and mortality. We evaluated our long-term outcomes of kidney transplants (KTx) in infants.

Methods: Between 1984 and 2014, 136 infants underwent KTx. We examined trends in survival rates and complications by era (1984-1993 [era 1], 1994-2003 [era 2], 2004-2014 [era 3]).

Results: Patients were 92.6% white and 70.6% males. Posttransplant (Tx) initial length of hospital stay declined 37% over the 30-year period (P <0.01). Ten-year death-censored graft survival improved from 60% (era 1) to 80% (era 2) (P = 0.04). The incidence of acute rejection, graft thrombosis, cytomegalovirus, and urine leaks did not significantly change across eras. Frequency of Epstein-Barr virus diagnosis (era 2 vs era 3, P < 0.01) increased. Post-Tx lymphoproliferative disorder incidence was increased in era 2 compared with eras 1 and 3 (P = 0.03).

Conclusions: Infants deserve earlier consideration for KTx. Length of initial hospital stay and patient and graft survival rates after KTx have improved in infants since 1984.

MeSH terms

  • Cause of Death
  • Female
  • Graft Survival
  • Humans
  • Infant
  • Infant, Newborn
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / mortality*
  • Length of Stay
  • Male
  • Survival Rate