Pubertal Development in Pediatric Kidney Transplant Patients Receiving Everolimus Or Conventional Immunosuppression
1Pediatric Nephrology, Hannover Medical School, Hannover, NDS, Germany
2Medical Statistics, University Medical Center Göttingen, Göttingen, NDS, Germany
3Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Meeting: 2015 American Transplant Congress
Abstract number: D211
Keywords: Kidney transplantation, Pediatric
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
TOR inhibitors (mTORi) have been discussed to eventually influence pubertal development after pediatric kidney transplantation (Tx).
This is the first trial to compare pubertal development in children with and without mTORi-treatment. The data of 108 children (66m), mean age at Tx 7 (SD 3) years have been evaluated with a mean observation time of 7 (SD 4) years. 67 patients were treated with an mTORi (40m). 41 patients were treated with CNI and Mycophenolate Mofetil without mTORi (26m). Steroid therapy was administered a mean of 5 (SD 4) years after Tx and then stopped. Data on the clinical signs of puberty (Tanner stages), serum levels of reproductive hormones and medication were analyzed.
The mean age at the onset of puberty was 12 years (SD 2) as compared to 13 (SD 2) years in males with and without mTORi. Mean age at menarche was 12 years (SD 2) in both groups and of spermarche 13 (SD 2) vs. 14 (SD 2) in children with and without mTORi. A delayed onset of puberty (> 2 SD) compared to healthy population data was recognized in 0/1 male and 0/0 female with and without mTORi. Elevated LH and/or FSH levels were found in 0/3 girls (age of first diagnosis 10 yrs.) and 8/4 boys (with mTORi: 7, 9, 10, 13, 14, 17 (n=3) yrs.// without mTORi: 10, 15, 15, 18 yrs.). Androstendion levels were decreased in 6/4 girls (age 13, 13, 14 (n=3), 17 // 12, 12, 13, 17 yrs.) and 4/4 boys (age 16, 17, 17, 18 // 13, 13, 16, 17 yrs.) with and without mTORi. DHEAS levels were decreased in 10/7 girls (age 10, 11 (n=4), 13, 14, 15, 16, 18 // 10, 10, 11 (n=4), 16 yrs.) and 14/7 boys (10, 11 (n=5), 12, 14, 15, 16, 16, 17, 17 // 11, 12 (n=5), 18 yrs) with and without mTORi. Testosterone was decreased in 9/6 boys (age 12 (n=4), 14 (n=5) / 12 (n=3), 13 (n=3) yrs.) with and without mTORi and Oestradiol in 3/2 girls (age 13, 17, 18 // 16, 18 yrs.). In the Fischer-exact test no differences were found between mTORi- and non-mTORi-group (p=0.23).
There were no differences in pubertal development and reproductive hormones between children treated with and without an mTORi after Tx resulting in a normal pubertal and sex hormone status in most of the patients.
To cite this abstract in AMA style:
Pape L, Ahlenstiel-Grunow T, Zapf A, Mynarek M, Förster J. Pubertal Development in Pediatric Kidney Transplant Patients Receiving Everolimus Or Conventional Immunosuppression [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/pubertal-development-in-pediatric-kidney-transplant-patients-receiving-everolimus-or-conventional-immunosuppression/. Accessed May 11, 2025.« Back to 2015 American Transplant Congress