A Decade of Paediatric Kidney Transplantation in Children Weighing <20kg.
1Transplant Surgery, Guy's and St Thomas and Evelina Childrens and Great Ormond Street Hospitals, London, United Kingdom
2Paediatric Nephrology, Evelina Childrens Hospitals, London, United Kingdom
3Paediatric Nephrology and Transplantation, Great Ormond Street Hospitals, London, United Kingdom
Meeting: 2017 American Transplant Congress
Abstract number: D161
Keywords: Donation, Pediatric, Renal failure, Survival
Session Information
Session Name: Poster Session D: Kidney: Pediatric
Session Type: Poster Session
Date: Tuesday, May 2, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Introduction: Renal transplantation is the gold standard treatment for end-stage kidney disease. There are increased challenges in paediatric renal transplant recipients under 20kg, especially when placing an adult kidney into a small abdomen.
Methods: Data was retrieved from a prospectively collected database, electronic records and hospital notes from two Paediatric Transplant Units in UK. eGFR was calculated using the Schwartz formula (Schwartz GJ, Pediatrics 1976 ;58:259-63). Death-censored graft survival and patient survival were assessed using Kaplan-Meier analysis.
Results: 420 children, who had a kidney transplant between 2005-2015, were reviewed. Group A (<20kg) included 116 (28%) and Group B (>20kg) had 303 (72%) cases. The median age (years) for Group A was 3 (IQR 2-4) and for Group B, 13 (IQR 10-15). This was significantly different (p<0.001). 108 (93%) Group A cases had a functioning graft at last follow up (6 failed, 2 died) versus 274 (90%) Group B cases (29 failed, 1 died). 3 (38%) losses in Group A and 14 losses (48%) in Group B were due to rejection. The overall median follow up was 2 years (IQR 1-5) with a maximum of 9 years. The median donor age (years) was 37 (IQR 30-42) and 41 (IQR 34-47) for Group A and B respectively (p<0.001). Group A included 85 (73%) live, 28 DBD and 3 DCD donors and Group B 179 (59%) live, 116 DBD and 8 DCD donors. 1/116 in Group A and 29/303 in Group B were re-transplants. The last median eGFR was 61 (IQR 48-74) and 51 (IQR 40-63) in Group A and B respectively (p<0.001). There was no significance difference between the groups with respect to graft and patient survival (log rank test p=0.276 and 0.130 respectively).
Discussion: Despite the obvious difference in age between the two groups, the overall patient and graft survival was similar between children <20kgs and >20kgs in this cohort.Transplantation in small children is feasible with good outcomes.
CITATION INFORMATION: Chandak P, Stojanovic J, Jamshaid F, Mamode N, Calder F, Olsburgh J, Callaghan C, Drage M, Koffman G, Marks S, Kessaris N. A Decade of Paediatric Kidney Transplantation in Children Weighing <20kg. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Chandak P, Stojanovic J, Jamshaid F, Mamode N, Calder F, Olsburgh J, Callaghan C, Drage M, Koffman G, Marks S, Kessaris N. A Decade of Paediatric Kidney Transplantation in Children Weighing <20kg. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/a-decade-of-paediatric-kidney-transplantation-in-children-weighing-20kg/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress