End Stage Kidney Disease Risk Profile in Living Kidney Donors for Pediatric versus Adult Kidney Transplant Recipients in Australia and New Zealand
1Department of Renal Medicine, Eastern Health, Melbourne, VIC, Australia
2Department of Nephrology, Austin Health, Melbourne, VIC, Australia
3Department of Nephrology, Royal Children's Hospital, Melbourne, VIC, Australia
4Department of Nephrology, St Vincent's Hospital, Melbourne, VIC, Australia.
Meeting: 2018 American Transplant Congress
Abstract number: D177
Keywords: Donation, Kidney transplantation, Pediatric, Renal failure
Session Information
Session Name: Poster Session D: Kidney Living Donor: Selection
Session Type: Poster Session
Date: Tuesday, June 5, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background: Living kidney donors (LKD) for pediatric kidney transplant recipients (KTR) have a high motivation to donate due to the clear benefits to the KTR compared to dialysis. We hypothesized that younger LKD with higher end-stage kidney disease (ESKD) risk were more often accepted for pediatric versus adult KTR.
Methods: ANZDATA LKD registry data (2004-2015) from Australia and New Zealand were used to compare baseline demographics and ESKD risk without donation for pediatric versus adult KTR using a risk calculator (Grams ME et al NEJM 2016).
Results: Compared to adult KTR, LKD for pediatric KTR were younger, more likely to be the parents of KTR (80.3% vs 20.6%; P<0.001), and had lower 15-year but higher lifetime ESKD risk (Table 1). Despite this, the proportion of LKD with lifetime risk of >1% was similar. Compared to LKD parents for pediatric KTR, grandparents donated to younger KTR and had higher 15-year but lower lifetime ESKD risk (Table 1).
Conclusions: LKD for pediatric KTR have lower 15-year but higher lifetime ESKD risk, primarily driven by donation from younger LKD parents, but the absolute risk difference is minor. As pediatric KTR require multiple transplants over their lifetime, grandparents with lower lifetime ESKD risk should be considered as an alternative LKD option, allowing younger parents to be LKD for subsequent transplants.
| LKD for Pediatric KTR
(n=315) |
LKD for Adult KTR
(n=3448) |
P | |
| LKD age (years) | 42 (37-49) | 50 (42-58) | <0.001 |
| 15-year ESKD risk (%) | 0.07 (0.05-0.11) | 0.10 (0.07-0.16) | <0.001 |
| Lifetime ESKD risk (%) | 0.44 (0.31-0.63) | 0.40 (0.26-0.59) | <0.01 |
| Lifetime ESKD risk >1% (n (%)) | 17 (5.4%) | 193 (5.6%) | >0.99 |
| Grandparent LKD for Pediatric KTR
(n=23) |
Parent LKD for Pediatric KTR
(n=253) |
P | |
| KTR age (years) | 3 (2-7) | 12 (6-15) | <0.001 |
| LKD age (years) | 59 (55-65) | 41 (37-47) | <0.001 |
| 15-year ESKD risk (%) | 0.11 (0.07-0.17) | 0.07 (0.05-0.11) | <0.001 |
| Lifetime ESKD risk (%) | 0.25 (0.16-0.50) | 0.44 (0.33-0.63) | <0.001 |
CITATION INFORMATION: Lee D., Whitlam J., Cook N., Walker A., Ierino F., Roberts M., Kausman J. End Stage Kidney Disease Risk Profile in Living Kidney Donors for Pediatric versus Adult Kidney Transplant Recipients in Australia and New Zealand Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Lee D, Whitlam J, Cook N, Walker A, Ierino F, Roberts M, Kausman J. End Stage Kidney Disease Risk Profile in Living Kidney Donors for Pediatric versus Adult Kidney Transplant Recipients in Australia and New Zealand [abstract]. https://atcmeetingabstracts.com/abstract/end-stage-kidney-disease-risk-profile-in-living-kidney-donors-for-pediatric-versus-adult-kidney-transplant-recipients-in-australia-and-new-zealand/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress