Format

Send to

Choose Destination
Nephrol Dial Transplant. 2017 Nov 1;32(11):1949-1956. doi: 10.1093/ndt/gfx261.

The association of donor and recipient age with graft survival in paediatric renal transplant recipients in a European Society for Paediatric Nephrology/European Renal Association-European Dialysis and Transplantation Association Registry study.

Author information

1
Department of Medical Informatics, ESPN/ERA-EDTA Registry and ERA-EDTA Registry, Amsterdam, The Netherlands.
2
Spaarne Gasthuis Academie, Spaarne Gasthuis, Hoofddorp, The Netherlands.
3
Department of Pediatric Nephrology, Emma Children's Hospital AMC, Amsterdam, The Netherlands.
4
Department of Pediatrics, Bordeaux University Hospital, Bordeaux, France.
5
Division of Paediatric Nephrology, University of Heidelberg, Center for Pediatrics and Adolescent Medicine, Heidelberg, Germany.
6
Department of Pediatrics, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
7
Pediatric Nephrology Unit, Toulouse University Hospital, Toulouse, France.
8
Department of Medicine, Zealand University Hospital, Roskilde, Denmark.
9
Erasmus Medical Center, Rotterdam, The Netherlands.
10
Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
11
Department of Pediatrics I, University Children's Hospital, Heidelberg, Germany.

Abstract

Background:

The impact of donor age in paediatric kidney transplantation is unclear. We therefore examined the association of donor-recipient age combinations with graft survival in children.

Methods:

Data for 4686 first kidney transplantations performed in 13 countries in 1990-2013 were extracted from the ESPN/ERA-EDTA Registry. The effect of donor and recipient age combinations on 5-year graft-failure risk, stratified by donor source, was estimated using Kaplan-Meier survival curves and Cox regression, while adjusting for sex, primary renal diseases with a high risk of recurrence, pre-emptive transplantation, year of transplantation and country.

Results:

The risk of graft failure in older living donors (50-75 years old) was similar to that of younger living donors {adjusted hazard ratio [aHR] 0.74 [95% confidence interval (CI) 0.38-1.47]}. Deceased donor (DD) age was non-linearly associated with graft survival, with the highest risk of graft failure found in the youngest donor age group [0-5 years; compared with donor ages 12-19 years; aHR 1.69 (95% CI 1.26-2.26)], especially among the youngest recipients (0-11 years). DD age had little effect on graft failure in recipients' ages 12-19 years.

Conclusions:

Our results suggest that donations from older living donors provide excellent graft outcomes in all paediatric recipients. For young recipients, the allocation of DDs over the age of 5 years should be prioritized.

KEYWORDS:

epidemiology; graft survival; paediatric nephrology; transplantation

PMID:
28992338
DOI:
10.1093/ndt/gfx261
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center