Background: Limited data exist on renal transplantation in children with intellectual disability (ID). In 2008, UNOS began collecting data on the cognitive and academic level of pediatric candidates.

Purpose: To describe the rates and outcomes of renal transplantation in children with intellectual disability (ID).

Methods: We performed a retrospective analysis of all children receiving a first kidney alone transplant in the UNOS dataset from 2008 to October 31, 2011. Recipients with and without ID were compared using chi-square and Fisher’s exact tests. Kaplan Meier curves were constructed for patient and graft survival.

Results: Over the study period, 218 children with intellectual disability underwent first renal transplant accounting for 17% of all first pediatric renal transplants (total n=1280). Children with ID tended to be younger (p=.0004), were more likely to be diagnosed with acute cortical necrosis (p=.01) and had a higher likelihood of receiving a deceased donor transplant (p=.02). Children with ID were not significantly different than children without ID with respect to ethnicity, rate of preemptive transplant, acute rejection, or treatment related hospitalizations. Graft and patient survival were similar in the two groups (log rank, p=0.8).

Conclusions: In this first large scale study, 17% of all first pediatric renal transplants are performed in children identified as having intellectual disability. Early outcomes after transplant are equivalent between children with and without ID. Further research is needed on long-term outcomes and quality of life effects of transplant in this population.

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