Is There a Difference in Patient and Graft Survival in Children Weighing <20 kg Versus Those Weighing >20 kg at the Time of Renal Transplantation?

P. Chandak,¹ J. Stojanovic,² R. Sivaprakasam,³ N. Mamode,¹ F. Calder,¹ J. Olsburgh,¹ M. Drage,¹ C. Callaghan,¹ J. Taylor,¹ G. Koffman,¹ J. Taylor,² S. Marks,⁴ N. Kessaris.¹

¹Transplant Surgery, Guys and St Thomas Hospitals NHS Trust, London, United Kingdom
²Nephrology, Evelina Childrens Hospital, London, United Kingdom
³Transplant Surgery, Royal London Hospital, London, United Kingdom
⁴Department of Nephrology and Transplantation, Great Ormond Street Hospital for Children, London, United Kingdom.

Meeting: 2015 American Transplant Congress

Abstract number: D218

Keywords: Graft survival, Pediatric, Renal failure, Surgical complications

Session Information

Session Name: Poster Session D: Pediatric Clinical Kidney Transplantation

Session Type: Poster Session

Date: Tuesday, May 5, 2015

Session Time: 5:30pm-6:30pm

Presentation Time: 5:30pm-6:30pm

Location: Exhibit Hall E

Introduction: Renal transplantation (RTx) is the gold standard treatment modality for end-stage kidney disease. There are increased challenges in pediatric renal transplant recipients (pRTR) under 20kg with immunological, metabolic and surgical difficulties.

Methods: Data was retrieved from a prospectively collected database (apart from the weight at time of transplant and the last eGFR, which was collected retrospectively) from two large Pediatric Transplant Units in UK. Cases with incomplete data were excluded.

Results: A total of 350 children underwent kidney transplantation between 2005 and 2014. Group 1 included 90 cases (57M, 33F) of pRTR with a weight <20kg (Median age 3, IQR 2.25) and Group 2 had 260 pRTR (146M, 114F) with a weight ≥20kg (Median age 13, IQR 5, p<0.001). 83 cases from Group 1 have a functioning graft at last follow up (5 failed, 2 died) and 230 in Group 2 (29 failed, 1 died). In Group 2 there were 5 en-bloc kidneys, one of which thrombosed intra-operatively. The median donor age (years) was 38 (IQR13) and 41 (IQR12) for Group 1 (66M, 24F) and 2 (142M, 117F) respectively (p<0.001). In Group1 there were 63 live donors, 25 DBD and 2 DCD donors. In Group 2 there were 150 live donors, 104 DBD and 6 DCD donors. 1/90 in Group 1 and 25/260 in Group 2 underwent their 2^nd or 3^rd transplant. The last median eGFR was 59 (IQR26) and 49 (IQR23) in Group 1 and 2 respectively (p<0.001). Both groups had equal median follow up of 3 years (IQR 4).

Conclusion: Despite the obvious differences between the two groups, we conclude that the overall patient and graft survival is comparable between children <20kgs and >20kgs at the time of transplantation in this large pediatric cohort.

To cite this abstract in AMA style:

Chandak P, Stojanovic J, Sivaprakasam R, Mamode N, Calder F, Olsburgh J, Drage M, Callaghan C, Taylor J, Koffman G, Taylor J, Marks S, Kessaris N. Is There a Difference in Patient and Graft Survival in Children Weighing <20 kg Versus Those Weighing >20 kg at the Time of Renal Transplantation? [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/is-there-a-difference-in-patient-and-graft-survival-in-children-weighing-20-kg-versus-those-weighing-20-kg-at-the-time-of-renal-transplantation/. Accessed November 23, 2024.

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