Effect of Pretransplant Dialysis Modality and Duration on Long-Term Outcomes of Children Receiving Renal Transplants

Butani, Lavjay; Perez, Richard V

doi:10.1097/tp.0b013e318204860b

Cited by 51 publications

(49 citation statements)

References 14 publications

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“…Twenty eight percent of pediatric recipients from 1995 to 2000 were preemptive and this group has the best 1-year allograft survival. Twenty eight percent of transplants followed HD, and 34% followed PD [33] . Butani et al [33] showed that longer duration of pre-transplant HD, but not PD, led to a linear increase in risk of allograft failure among living donor recipients.…”

Section: Transition To Esrd Therapiesmentioning

confidence: 99%

See 1 more Smart Citation

A Review of Pediatric Chronic Kidney Disease

Kaspar

Bholah²,

Bunchman³

2016

Blood Purif

114

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Section: Transition To Esrd Therapiesmentioning

confidence: 99%

“…Twenty eight percent of transplants followed HD, and 34% followed PD [33] . Butani et al [33] showed that longer duration of pre-transplant HD, but not PD, led to a linear increase in risk of allograft failure among living donor recipients. Transplantation conveys a 4-fold higher survival benefit compared to dialysis.…”

Section: Transition To Esrd Therapiesmentioning

confidence: 99%

A Review of Pediatric Chronic Kidney Disease

Kaspar

Bholah²,

Bunchman³

2016

Blood Purif

114

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“…The mean age of all patients when transplanted was 13.2 AE 5.2 yr (range [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19], and 48% were male. One recipient in the DD group received two DD transplants during the study period.…”

Section: Resultsmentioning

confidence: 99%

“…In an (16). In addition, other studies that have examined variables associated with allograft survival have identified LD source to be associated with a survival advantage (8,18). While donor source is not the only predictor of long-term graft survival, it clearly plays a critical role with LDs providing the most durable option in pediatric recipients.…”

Section: Discussionmentioning

confidence: 96%

Organ allocation in pediatric renal transplants: is there an optimal donor?

Pitt

Vachharajani

Doyle

et al. 2013

Clinical Transplantation

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The 2005 revised allocation scheme for pediatric renal transplantation made the decision of whether to transplant an available living-donor (LD) kidney or use a deceased-donor (DD) kidney controversial. The aim of this study was to examine kidney allograft utilization, sensitization, and outcomes of pediatric transplant recipients. Between January 2000 and December 2009, 91 consecutive pediatric kidney recipients (<20 yr) were transplanted. The LD (n = 38) and DD (n = 53) groups were similar in age, gender, dialysis status at transplant, warm ischemia time, and overall patient survival. LD recipients were more likely to be Caucasian (92 vs. 69%), receive older allografts (39 ± 10 vs. 23 ± 9 yr), and have fewer human leukocyte antigen (HLA) mismatches (3.3 ± 1.6 vs. 4.4 ± 1.5, p < 0.01 for all). Graft survival at one, three, and five yr post-transplant was longer for LD recipients (97%, 91%, 87% vs. DD 89%, 79%, 58%, respectively, p < 0.05). At the time of transplant, 17 (33%) DD recipients had an available LD (mean age 40 yr). A greater proportion of all patients were moderately (PRA 21-79%) sensitized post-transplant (p < 0.05). A multivariable analysis of graft survival indicated that the advantage in LD organs was likely due to fewer HLA mismatched in this group. Nonetheless, LD organs appear to provide optimal outcomes in pediatric renal transplants when considering the risk of becoming sensitized post-transplant complicating later use of the LD kidney.

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“…Children with end stage renal disease are especially vulnerable to the organ shortage, since their psychosocial and neurodevelopmental functioning is adversely affected by the uremic environment and any delay in transplanting them can have long term ramifications. Moreover, pre-emptive transplantation has been shown to improve long term graft survival in children [2] . These considerations have made it critical for health-care providers to minimize wait times on dialysis.…”

Section: Introductionmentioning

confidence: 99%