Outcome of renal transplantation in children: A multi‐center national report from Iran

Abstract

The outcome of pediatric renal transplantation was previously reported by a single-center study at the year 2006. Therefore, we aimed to evaluate and report the characteristics and outcome of renal pediatric renal transplantation in a multi-center nationwide study. In this nationwide report, medical records of 907 children (≤18yr) with renal transplantation in eight major pediatric transplant centers of Iran were recorded. These 907 patients received a total of 922 transplants. All children who failed to follow-up were excluded. Rather than baseline characteristics, graft and patient outcomes were considered for survival analysis. For further analysis, they were divided into two groups: patients who had graft survival time more than 10yr (n=91) and the ones with graft survival time of equal or less than 10yr (n=831). Of 922 recipients, 515 (55.8%) were boys and 407 (44.2%) were girls with the mean age of 13.10 (s.d.=3.54) yr. DGF and AR were occurred in 10% and 39.5% of the transplanted children, respectively. Transplantation year, dialyzing status before transplantation, DGF, and AR were significant enough to predict graft survival in cox regression model (overall model: p<0.001). Nowadays, there is a successful live donor pediatric renal transplantation in Iran. Graft survival has improved in our recipients and now the graft survival rates are near to international standards.

Pediatric kidney transplantation in Egypt: Results of 10‐year single‐center experience

“…The NAPRTCS registry data show 1‐ and 5‐year graft survival rates of 95.5% and 85.7% (1995‐2010) in living‐donor pediatric KT 13 . The outcome of KT in this study is better than previous pediatric reports 5,27,44 . Our 1, 3, 5, and 10 graft/patient survival rates are 91.9%, 91.8%, 89.2%, and 58.3%, respectively.…”

“…It was reported that episodes of AR are associated with poor long‐term survival rates 11,27,28 . In our series; a total of 48 patients developed at least one AR episode during 688 patient‐years of follow‐up (7% per patient‐year overall and 4.4% after the first year).…”

“…Chronic active AMR was the most common pathological type of late rejection among our cohort (12/29 patients). Eight of these patients developed graft failure in few months, consistent with chronic AMR being the most common cause of graft failure 6,10,13,27 …”

The impact of changing practice on improved outcomes of paediatric renal transplantation in the United Kingdom: a 25 years review

“…This compares favourably to published long-term outcome from national and regional registries. The published studies on the outcome of paediatric renal transplants are summarised in Table 4 [18][19][20][21][22][23][24][25][26][27][28][29].…”

Focal segmental glomerulosclerosis in pediatric kidney transplantation: 30 years’ experience

“…A remarkable finding in our cohort was the exceedingly high rate (64%) of early graft dysfunction in those with recurrent FSGS, which is 2.5‐fold higher than in nonrecurrent FSGS and 5‐fold higher compared to the general pediatric NIKTR data. The reported early graft dysfunction rate is 5–10% in pediatric KT . The differential diagnosis in this condition usually includes acute tubular necrosis (ATN) and acute rejection.…”