Pediatric Renal Transplantation: Evaluation of Long-Term Outcomes and Comparison to Adult Population

Transplant Proc. 2018 Jun;50(5):1264-1271. doi: 10.1016/j.transproceed.2018.02.089.

Abstract

Background: In Europe, pediatric transplantation accounts for only about 4% of all kidney transplantations performed. The aim of our work is to evaluate the evolution of pediatric renal transplantation in our department over time, but also to compare this special population with the adult one.

Methods: We evaluated all pediatric renal transplantations performed in our department between January 1981 and December 2016. We performed the analysis of clinical, analytical, and surgical factors to look for predictive factors of graft loss or decrease of survival. In addition, we performed a comparative study of pediatric and adult populations and an evaluation of the evolution of pediatric renal transplantation in our department over time.

Results: We evaluated 101 renal transplantations performed in patients younger than 18 years. Pediatric transplantations corresponded to 3.4% of all renal transplantations performed in our department. The rate of living donors was 12%. Donors of grafts for the pediatric population were significantly younger than in the adult population. The increase in donor age was associated with lower renal graft survival rates. Acute rejections were more frequent in the pediatric population. Eleven pediatric recipients (10.9%) died in the follow-up period. Renal graft survival in the pediatric population was 94.8%, 77.4%, and 66.5% at 1, 5, and 10 years, respectively. There was no significant difference in graft survival in the pediatric and adult population. The pediatric overall survival rate at 1, 5 and 10 years was 97.9%, 96.8%, and 91.9%, respectively.

Conclusion: Pediatric renal transplantation presents results identical to those identified in adults.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Child
  • Europe
  • Female
  • Graft Survival
  • Humans
  • Kidney Failure, Chronic / etiology*
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / methods*
  • Kidney Transplantation / mortality*
  • Living Donors / statistics & numerical data
  • Male
  • Middle Aged
  • Survival Rate
  • Treatment Outcome