Outcomes and predictive factors of pediatric kidney transplants: An analysis of the Thai Transplant Registry

Abstract

As universal coverage for pediatric kidney transplantation (KT) was introduced in Thailand in 2008, the number of recipients has been increasing. We evaluated predictive factors for graft failure to understand how to improve clinical outcomes in these children. Using data obtained from the National Transplant registry, we assessed the risk of graft failure using the Kaplan-Meier method and Cox proportional hazards regression. Altogether, 201 recipients aged <21 yr at the time of KT were studied. Living donors (LD) were significantly older than deceased donor (DD). Mean cold ischemia time of DD was 17 h. The mean donor glomerular filtration rate (GFR) was 84.0 mL/min/1.73 m(2) . Induction immunosuppressive therapy was administered more frequently in DD than in LDKT. Delayed graft function (DGF) occurred in 36 transplants. Over 719 person years of follow-up, 42 graft failures occurred. Graft survival at one, three, and five yr post-transplant were 95%, 88% and 76%, respectively. Two factors independently predicted graft failure in multivariate analysis. The hazard ratios for graft failure in patients with DGF and in patients with donor GFR of ≤30 mL/min/1.73 m(2) were 2.5 and 9.7, respectively. Pediatric recipients should receive the first priority for allografts from young DD with a good GFR, and DGF should be meticulously prevented.

Outcomes of pediatric deceased donor kidney transplant in northeast Thailand

“…In this study, the majority of KT recipients were male, and the most common etiology of ESRD was congenital anomalies of the kidneys and urinary tract, both of which are consistent with previously published reports 3–10 . However, there were no patients with ESRD caused by obstructive uropathy, which is more common in boys.…”

A 25‐year experience of kidney transplantation in Thailand: Report from the Thai Transplant Registry

“…Since then, kidney transplant data in the country has been collected, analyzed, and presented yearly at the Annual Meeting of Thai Transplantation Society, in addition to several articles being published using this data. [4][5][6][7] This is the first report regarding kidney transplant activity and survival data from a large registry from a South-East Asian country, which is a relatively resource-limited area. The objective of this report was to describe kidney transplant characteristics and survival data during the past 25 years in Thailand.…”

“…Although the first kidney transplant in Thailand was in 1975, patient registry and systematic data collection was not begun until 2002. Since then, kidney transplant data in the country has been collected, analyzed, and presented yearly at the Annual Meeting of Thai Transplantation Society, in addition to several articles being published using this data . This is the first report regarding kidney transplant activity and survival data from a large registry from a South‐East Asian country, which is a relatively resource‐limited area.…”

AsPNA

“…As of 2010, a total of 201 patients were transplanted with the majority of kidney allografts (67 %) coming from deceased donors. The graft survival rates at 1 and 5 years posttransplant were 95 % and 76 %, respectively [80]. The most common pediatric kidney diseases are primary nephrotic syndrome, acute glomerulonephritis, CAKUT, urinary tract infection, and lupus nephritis.…”