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Outcomes and predictive factors of pediatric kidney transplants: An analysis of the T hai T ransplant R egistry
Author(s) -
Rianthavorn Pornpimol,
Kerr Stephen J.,
Lumpaopong Adisorn,
Jiravuttipong Apichat,
Pattaragarn Anirut,
Tangnararatchakit Kanchana,
Avihingsa Yingyos,
Thirakupt Prapaipim,
Sumethkul Vasant
Publication year - 2013
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.12047
Subject(s) - medicine , proportional hazards model , hazard ratio , renal function , urology , kidney transplantation , kidney , transplantation , surgery , kidney transplant , confidence interval
Abstract As universal coverage for pediatric kidney transplantation ( KT ) was introduced in T hailand in 2008, the number of recipients has been increasing. We evaluated predictive factors for graft failure to understand how to improve clinical outcomes in these children. Using data obtained from the N ational T ransplant registry, we assessed the risk of graft failure using the K aplan– M eier method and C ox proportional hazards regression. Altogether, 201 recipients aged <21 yr at the time of KT were studied. Living donors ( LD ) were significantly older than deceased donor ( DD ). Mean cold ischemia time of DD was 17 h. The mean donor glomerular filtration rate ( GFR ) was 84.0 mL/min/1.73 m 2 . Induction immunosuppressive therapy was administered more frequently in DD than in LDKT . Delayed graft function ( DGF ) occurred in 36 transplants. Over 719 person years of follow‐up, 42 graft failures occurred. Graft survival at one, three, and five yr post‐transplant were 95%, 88% and 76%, respectively. Two factors independently predicted graft failure in multivariate analysis. The hazard ratios for graft failure in patients with DGF and in patients with donor GFR of ≤30 mL/min/1.73 m 2 were 2.5 and 9.7, respectively. Pediatric recipients should receive the first priority for allografts from young DD with a good GFR , and DGF should be meticulously prevented.