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

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 m 2 ), 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.