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A comparison of post‐transplant renal function in pre‐emptive and post‐dialysis pediatric kidney transplant recipients
Author(s) -
Kim Jin K.,
Lorenzo Armando J.,
Farhat Walid A.,
Chua Michael E.,
Ming Jessica M.,
Dos Santos Joana,
Koyle Martin A.
Publication year - 2019
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.13377
Subject(s) - medicine , dialysis , renal transplant , renal function , kidney transplant , transplantation , retrospective cohort study , kidney transplantation , kidney , etiology , gastroenterology
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.