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Pediatr Transplant. 2019 May;23(3):e13377. doi: 10.1111/petr.13377. Epub 2019 Feb 8.

A comparison of post-transplant renal function in pre-emptive and post-dialysis pediatric kidney transplant recipients.

Author information

1
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
2
Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada.
3
Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
4
nstitute of Urology, St. Luke's Medical Center, Quezon City, Philippines.
5
Department of Surgery, University of New Mexico, Albuquerque, NM, USA.
6
Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.

Abstract

PURPOSE:

Little is known regarding post-transplant renal function following pediatric pre-emptive KT. Therefore, this study aims to determine whether there is a difference in 1 year post-transplant renal function outcomes between pre-emptive and post-dialysis KT in pediatric transplant recipients.

METHODS:

A retrospective review of patients who underwent kidney transplant at our institution between 2000 and 2015 was performed. Kidney transplant recipients were divided into four groups: pre-DD, post-DD, pre-LD, and post-LD. The clinical outcomes, measured in eGFR (mL/min/1.73 m2 ), acute rejection episodes within 1 year, and hospitalization within 1 year were compared to between groups in their respective donor types (pre-DD vs post-DD; pre-LD vs post-LD).

RESULTS:

The 324 patients were identified (21 pre-DD, 151 post-DD, 54 pre-LD, and 98 post-LD). Post-DD group had more females (P = 0.018) and post-operative complications (P = 0.023), although there was no difference in complications requiring intervention (P = 0.129). Post-LD patients were more likely to be females (P = 0.017) and those with intrinsic renal (non-urological/structural) ESRD etiology (P = 0.003). The 1-year eGFR was similar between pre-DD and post-DD groups (70.3 [IQR 53.5-88.5] vs 74.3 [IQR 62.3-90.5], P = 0.613), as well as pre-LD and post-LD groups (66.6 [IQR 47.8-73.7] vs 63.9 [IQR 55.0-77.1], P = 0.600). There were no significant differences in rates of acute rejection episodes or hospitalization within 1 year of transplantation for in LD/DD groups.

CONCLUSION:

There is no significant difference in renal function at 1 year post-transplant in pediatric patients receiving pre-emptive or post-dialysis kidney transplants.

KEYWORDS:

kidney transplantation; pediatric; post-dialysis; pre-emptive; renal function

PMID:
30735602
DOI:
10.1111/petr.13377

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