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Nephrol Dial Transplant. 2012 Apr;27(4):1672-6. doi: 10.1093/ndt/gfr549. Epub 2011 Oct 10.

The influence of low donor age, living related donation and pre-emptive transplantation on end-organ damage based on arterial hypertension after paediatric kidney transplantation.

Author information

1
Department of Pediatric Nephrology, Hannover Medical School, Hannover, Germany.

Abstract

BACKGROUND:

To date, no study has described the pre-transplant and transplant risk factors for end-organ damage based on arterial hypertension in children after kidney transplantation (KTX).

METHODS:

A retrospective chart review was performed of 206 children with KTX between 1991 and 2007. Patients<120 cm were excluded as no validated percentiles for 24-h ambulant blood pressure monitoring (ABPM) exist. Complete data sets were available for 116 patients. Data were recorded at 12, 24 and 36 months post- KTX. We analysed the influence of donor age, age at transplantation, pre-emptive transplantation, living or deceased transplantation and glomerular filtration rate (GFR) on the presence of end-organ damage, ABPM, ABPM standard deviation score and the numbers of anti-hypertensives used.

RESULTS:

Lower donor age and the decade of transplantation were associated with less detection of end-organ damage (P=0.001). A lower need for anti-hypertensive medication (P=0.001) was detected in children who received organs from living donors and from deceased donors with a donor age<35 years and who were transplanted pre-emptively. Low recipient age was the only factor associated with lower ABPM (P=0.001). In our study, the type of immunosuppressive regimen and the GFR had no influence on the blood pressure.

CONCLUSIONS:

It may be speculated that the risk of arterial hypertension and associated end-organ damage in children after KTX could be reduced by using organs from young donors with an advantage for living related and pre-emptive donation.

PMID:
21987537
DOI:
10.1093/ndt/gfr549
[Indexed for MEDLINE]

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