Background. Pediatric transplant recipients are typically transitioned to adult transplant programs for post-transplant care after age 18. For pediatric kidney (KI) recipients transitioning to adult providers, the follow-up care is sometimes transferred to an adult nephrologist who is not affiliated with a transplant center and who does not report to OPTN, possibly contributing to higher likelihood of being lost to follow-up (LTF) in this group of recipients. For heart (HR) and liver (LI), the care is typically transferred to an adult transplant program. The current analysis was conducted for the OPTN Pediatric Committee to quantify the rates of LTF in pediatric recipients of HR, KI, and LI transplants in order to plan for future interventions to improve follow-up.

Data and Methods. OPTN database was analyzed for pediatric recipients of solitary HR, KI, and LI transplants during 2000-2010. Kaplan-Meier extension of competing risk method was used to estimate the rates of LTF as reported by transplant programs, stratified by organ and age group at transplant (0-5, 6-11, 12-17, 18-25, 26+).

Results. Table 1 shows cumulative LTF rates within 10 yrs of transplant by organ and age group at transplant. The highest LTF rate at 10 years was observed in adolescent and young adult recipients of KI transplants ((21% and 22%, respectively). The lowest LTF rate was seen in the youngest age group of HR recipients (2.3%).Conclusions. This analysis confirmed that LTF is most common in KI and less common in HR. Patients receiving a KI transplant as an adolescent or young adult had the highest LTF rates within 10 yrs. More accurate ascertainment of long-term follow-up data is necessary to better estimate long term survival. The Pediatric Committee continues to work on educational and outreach strategies for improving long-term follow-up among pediatric recipients, particularly those transitioning into adulthood.

CITATION INFORMATION: Cherikh W, Bartosh S, Urban R, Mahle W, Mazariegos G, Brewer E. Rates of Lost to Follow-Up Among Pediatric Heart, Kidney, and Liver Transplant Recipients. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress