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Disparities in Policies, Practices and Rates of Pediatric Kidney Transplantation in Europe
Author(s) -
Harambat J.,
van Stralen K. J.,
Schaefer F.,
Grenda R.,
Jankauskiene A.,
Kostic M.,
Macher M.A.,
Maxwell H.,
Puretic Z.,
Raes A.,
Rubik J.,
Sørensen S. S.,
Toots Ü.,
Topaloglu R.,
Tönshoff B.,
Verrina E.,
Jager K. J.
Publication year - 2013
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.12288
Subject(s) - medicine , interquartile range , kidney transplantation , harmonization , incidence (geometry) , prioritization , transplantation , pediatrics , environmental health , demography , family medicine , intensive care medicine , physics , management science , sociology , acoustics , optics , economics
Abstract We aimed to provide an overview of kidney allocation policies related to children and pediatric kidney transplantation (KTx) practices and rates in Europe, and to study factors associated with KTx rates. A survey was distributed among renal registry representatives in 38 European countries. Additional data were obtained from the ESPN/ERA‐EDTA and ERA‐EDTA registries. Thirty‐two countries (84%) responded. The median incidence rate of pediatric KTx was 5.7 (range 0−13.5) per million children (pmc). A median proportion of 17% (interquartile range 2−29) of KTx was performed preemptively, while the median proportion of living donor KTx was 43% (interquartile range 10−52). The median percentage of children on renal replacement therapy (RRT) with a functioning graft was 62%. The level of pediatric prioritization was associated with a decreased waiting time for deceased donor KTx, an increased pediatric KTx rate, and a lower proportion of living donor KTx. The rates of pediatric KTx, distribution of donor source and time on waiting list vary considerably between European countries. The lack of harmonization in kidney allocation to children raises medical and ethical issues. Harmonization of pediatric allocation policies should be prioritized.