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Across all solid organs, adolescent age recipients have worse transplant organ survival than younger age children: A US national registry analysis
Author(s) -
Dharnidharka Vikas R.,
Lamb Kenneth E.,
Zheng Jie,
Schechtman Kenneth B.,
MeierKriesche HerwigUlf
Publication year - 2015
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.12464
Subject(s) - medicine , multivariate analysis , multivariate statistics , proportional hazards model , survival analysis , univariate , demography , univariate analysis , young adult , overall survival , pediatrics , statistics , mathematics , sociology
Univariate analyses suggest that adolescents have worse long‐term allograft survival versus younger children across different SOT . This study's objective was to determine whether multivariate analyses of a large national database recording all deceased SOT ( KI ; LI ; HR ; LU ) also show worse adolescent allograft survival in the different organs. Using data from the national S cientific R egistry for T ransplant R ecipients in the USA for pediatric primary SOT from 1989 to 2010, we calculated median half‐lives and constructed K – M graft survival curves. Recipient age at transplant (<12 or adolescent 12–17 yr) was fitted with other identical covariates into multivariate C ox proportional hazards models. In all SOT recipients, unadjusted graft survival curves demonstrated better graft survival for adolescents initially, followed by crossing of the lines, such that adolescent SOT recipients had worse survival after one yr ( KI ), 4.6 yr ( LI ), 4.4 yr ( HR ), and 1.6 yr ( LU ). Multivariate models of the post‐cross period showed a significantly higher AHR for worse graft survival in adolescent age across all four SOT s: AHR 1.400 ( KI ), 1.958 ( LI ), 1.414 ( HR ), and 1.576 ( LU ). Improving adolescent long‐term outcomes across all four organs will be a defining issue in the future.