Background: The role of donor peak and terminal creatinine on short and long term allograft outcomes in pediatric kidney transplant recipients is unclear.

Aim: To determine the association between donor peak and terminal creatinine and graft outcomes in a national cohort of pediatric kidney transplant recipients.

Methods: Using the Scientific Registry of Transplant Recipients database, we identified all pediatric kidney transplant (KT) recipients (<18 years at time of deceased donor KT). Recipients were excluded if they were lost to follow up or if no donor terminal creatinine was available. The terminal and peak creatinine were stratified into tertiles (0-1.99, 2-2.99 and ≥3 mg/dl).

Results: During the study period, there were 10090 transplant episodes for recipients less than 18 years of age eligible for inclusion. African-Amerian donors were significantly more likely to have a peak creatinine between 2-3 mg/dL (p=0.02). There were no significant differences in donor or recipient age, donor HTN, gender,delayed graft function, acute rejection. There was no significance in graft survival for either the donor maximum creatinine (p=0.75) or terminal creatinine (p=0.15) using Kaplan-Meier estimates . Multivariate logistic regression showed that neither the donor maximum or peak creatinine were independent predictors of graft loss in pediatric kidney transplant recipients.

Conclusions: An increased donor terminal or peak creatinine is not significantly associated with higher acute rejection or graft loss. Utilization of organs from these donors may be considered in sensitized patients, or children in geographical regions with longer wait times.

CITATION INFORMATION: Hayde N, Del Rio M. Donor Creatinine and Graft Outcomes in Pediatric Kidney Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).

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