Outcome of Pre-Emptive Kidney Transplantation in Children Under 6 Years of Age; A Single Center Experience in Japan
1Nephrology, Toho University Faculty of Medicine, Tokyo, Japan, 2Pediatric Nephrology, Toho University Faculty of Medicine, Tokyo, Japan
Meeting: 2022 American Transplant Congress
Abstract number: 839
Keywords: Graft survival, Kidney transplantation, Pediatric, Renal function
Topic: Clinical Science » Kidney » 43 - Kidney: Pediatrics
Session Information
Session Time: 5:30pm-7:00pm
Presentation Time: 5:30pm-7:00pm
Location: Hynes Halls C & D
*Purpose: Kidney transplantation (KT) is the preferred treatment for pediatric end stage renal disease, and pre-emptive kidney transplantation (PEKT) may reduce morbidity and mortality. KT for small children is considered technically challenging, incurring a higher risk of potential surgical and vascular complications. The aim of this study was to investigate whether there is a difference in outcome after pediatric KT between PEKT and non-PEKT in small children.
*Methods: We performed a retrospective cohort study on pediatric kidney transplant recipients, under 6 years of age, who received their first living-related kidney transplant between January 2002 and June 2018. Patients with bone metabolism disorders were excluded from the study. Patients were divided into two groups according to PEKT group or non-PEKT group, and clinical data were extracted from the medical records.
*Results: Among the 147 children (aged <18 years) who underwent first living-donor KT during the study period, 54 children (36.7%) were performed KT under 6 years of age. The median duration of follow-up was 7.9 years (IQR 5.5-10.8). Main baseline demographic data were not significantly between non-PEKT group (n=42) and PEKT group (n=12), age (3.7±1.2 vs 4.0±0.9 years, p=0.47), height SDS (-2.8±1.3 vs -2.5±1.0, p=0.59), body weight (11.3±2.4 vs 12.5±2.6 kg, p=0.15), estimated glomerular filtration rate (eGFR) of donor (85.9±16.9 vs 86.6±22.8 ml/min/1.73m2, p=0.92). The average duration of dialysis in the non-PEKT group were 2.7±1.3 years. Graft survival at 5 years was 98% and 100% in non-PEKT group and PEKT group, respectively (p=0.61). Vascular complications occurred in one patient in non-PEKT group, with subsequent early graft loss. All patients were alive during the study period. eGFR at 5 years post-transplant was comparable between the groups (64.0±17.2 vs 69.5±9.0 ml/min/1.73m2, respectively, p=0.39). The average height SDS were not significantly between non-PEKT group and PEKT group, -2.2±1.3 vs -2.5±1.0, -1.8±1.2 vs -1.5±1.3, -1.9±1.3 vs -1.7±1.3 at 1, 3, and 5 years post-KT, respectively.
*Conclusions: Kidney transplantation in small children was safe and technically feasible. From our series, there was no difference in 5 years-post KT patient and graft survival, graft function, growth between non-PEKT and PEKT group.
To cite this abstract in AMA style:
Aoki Y, Hamasaki Y, Hashimoto J, Zaitsu A, Kubota M, Muramatsu M, Kawamura T, Shishido S, Sakai K. Outcome of Pre-Emptive Kidney Transplantation in Children Under 6 Years of Age; A Single Center Experience in Japan [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/outcome-of-pre-emptive-kidney-transplantation-in-children-under-6-years-of-age-a-single-center-experience-in-japan/. Accessed May 6, 2025.« Back to 2022 American Transplant Congress