Long-term outcomes during 37 years of pediatric kidney transplantation: a cohort study comparing ethnic groups

Pediatr Nephrol. 2021 Jan 18. doi: 10.1007/s00467-020-04908-6. On-line forward of print.

ABSTRACT

BACKGROUND: This research aimed to judge short- and long-term outcomes of kidney transplantation over 37 years in a nationwide referral middle and examine outcomes between Israeli Jewish and Arab kids.

METHODS: Information on 599 pediatric transplantations carried out in 545 kids throughout 1981-2017, together with demographic parameters, kidney failure illness profile, and pre-transplant dialysis period, had been retrieved from our computerized database and affected person recordsdata. Affected person and graft survival had been estimated utilizing the Kaplan-Meier technique.

RESULTS: Twenty-year affected person survival was 91.4% for stay donor (LD) and 80.2% for deceased donor (DD) kidney recipients. Respective 10-year and 20-year graft survival charges for first kidney-only transplants had been 75.2% and 47.0% for LD and 60.7% and 38.4% for DD grafts. Lengthy-term graft survival improved considerably (p < 0.001) over the research interval for recipients of each LD and DD allografts and reached 7-year graft survival of 92.0% and 71.3%, respectively. The proportion of DD transplantations was increased within the Arab subpopulation: 73.8% vs. 48.4% (p < 0.001). Graft survival was not related to age at transplantation and didn’t differ between the Arab (N = 202) and Jewish kids (N = 343). Median (IQR) ready time on dialysis didn’t differ considerably between the Arab and Jewish kids: 18 (10-30) and 15 (9-30) months, respectively (p Mann-Whitney = 0.312).

CONCLUSIONS: Good and progressively enhancing long-term outcomes had been obtained in pediatric kidney transplantation at our nationwide referral middle, apparently on account of experience gained over time and advances in immunosuppression. Equal entry to DD kidney transplant and comparable graft survival had been discovered between ethnic teams.

PMID:33459932 | DOI:10.1007/s00467-020-04908-6