Hospitalization following pediatric kidney transplantation: An international comparison among a Canadian pediatric transplant center, North American Pediatric Renal Trials and Collaborative Studies, and Cooperative European Pediatric Renal Transplant Initiative registry data

Jin K Kim; Armando J Lorenzo; Burkhard Tönshoff; Michael E Chua; Lucshman Raveendran; Kai Krupka; Chia Wei Teoh; Jessica M Ming; Rezan Topaloglu; Luca Dello Strologo; Walid A Farhat; Martin A Koyle

doi:10.1111/petr.14273

Hospitalization following pediatric kidney transplantation: An international comparison among a Canadian pediatric transplant center, North American Pediatric Renal Trials and Collaborative Studies, and Cooperative European Pediatric Renal Transplant Initiative registry data

Pediatr Transplant. 2022 Aug;26(5):e14273. doi: 10.1111/petr.14273. Epub 2022 Mar 27.

Authors

Jin K Kim^{1

2}, Armando J Lorenzo^{1

2}, Burkhard Tönshoff³, Michael E Chua^{1

2}, Lucshman Raveendran¹, Kai Krupka³, Chia Wei Teoh^{4

5}, Jessica M Ming⁶, Rezan Topaloglu⁷, Luca Dello Strologo⁸, Walid A Farhat⁹, Martin A Koyle^{1

2}

Affiliations

¹ Division of Urology, Department of Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
² Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
³ Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany.
⁴ Division of Nephrology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁵ Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.
⁶ Department of Surgery, University of New Mexico, Albuquerque, New Mexico, USA.
⁷ Division of Pediatric Nephrology, Hecettepe University Faculty of Medicine, Ankara, Turkey.
⁸ Renal Transplantation Clinic, Bambino Gesu Children's Hospital IRCCS, Rome, Italy.
⁹ Department of Urology, University of Wisconsin, Madison, Wisconsin, USA.

PMID: 35340109
DOI: 10.1111/petr.14273

Abstract

Background: There are several databases across the world that collect pediatric KT data. We compare the hospitalization outcomes for pediatric KT recipients from a large Canadian transplant center (SickKids database; The Hospital for Sick Children Kidney Transplantation Institutional Database), United States (NAPRTCS), and Europe (CERTAIN registry).

Methods: An institutional retrospective review of KT was performed between 2000 and 2015. Baseline characteristics, duration of initial hospitalization/readmission at 1-5 and 6- to 11-month posttransplant, and 1-year graft survival data were collected. Corresponding data from the NAPRTCS 2014 Annual Transplant Report and CERTAIN registry were compared.

Results: Posttransplant, patients from NAPRTCS had the shortest duration of hospitalization within the first month (10.4 days, SE 0.2), followed by SickKids (20.3 days, SE 0.7) and CERTAIN (25.5 days, SE 0.7). For both living and deceased donor populations, patients from SickKids were most likely to be hospitalized at 1- to 5-month posttransplant (82.4% [89/108]; 72.1% [98/136]), followed by Europe (52.1% [198/380]; 61.6% [501/813]) and United States (45.4% [2379/5241]; 51.4% [2517/4896]). Patients from Europe were most likely to be hospitalized at 6- to 12-month posttransplant (42.1% [160/380]; 51.7% [420/813]), followed by SickKids (35.2% [38/108]; 37.5% [51/136]) and United States (28.3% [1387/4901]; 31.6% [1411/4465]). Across all databases, the most commonly addressed issues during readmissions were infectious complications.

Conclusion: The differences observed in this investigation may reflect the local reimbursement models, resources for outpatient management, and practice variations across a large Canadian transplant center, United States, and European countries.

Keywords: NAPRTCS; comparison; hospitalization; kidney transplant; pediatric.

MeSH terms

Canada
Child
Graft Rejection / etiology
Graft Survival
Hospitalization
Humans
Kidney Transplantation*
Registries
United States