Re-Hospitalization after Pediatric Kidney Transplantation in Steroid Avoidance Protocols
University of Minnesota, Minneapolis.
Meeting: 2018 American Transplant Congress
Abstract number: B239
Session Information
Session Name: Poster Session B: Kidney: Pediatrics
Session Type: Poster Session
Date: Sunday, June 3, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Data on re-hospitalization rates in steroid avoidance protocols is limited. We performed a single-center, retrospective cohort study of pediatric kidney transplant recipients between 2006 and 2016 to examine re-hospitalization patterns based on whether they were discharged on steroids post-transplant admission. Of the 200 children, 3 were eliminated due to graft loss or death during initial kidney transplant admission; 123 and 74 were discharged on steroid-avoidance and steroid-inclusive protocols. Both cohorts were similar except steroid avoidance patients were significantly older. Re-hospitalization rates; time to re-hospitalization; length and number of re-hospitalizations were not different (p 0.38; 0.1; 0.56; 0.11).
| Steroid Avoidance (n=123) | Steroid Inclusive (n=74) | P value | |
| Male | 68 (55.3%) | 45 (60.8%) | 0.45 |
| Age at transplant | 12.2 ± 4.5 | 5.9 ± 5.6 | <0.0001 |
| Caucasian
African American Amer-Indian/Alaska Nat Asian Unknown |
96 (78%)
6 (4.9%) 7 (5.7%) 12 (9.8%) 2 (1.6%) |
57 (77%)
7 (9.5%) 7 (9.5%) 3 (4.1) 0 |
0.23 |
| CAKUT
FSGS Congenital NS/Alport Glomerulonephritis Other |
64 (52%)
22 (17.8%) 3 (2.4%) 7 (5.7%) 27 (21.9%) |
44 (59.4%)
7 (9.5%) 10 (13.5%) 0 13 (17.6%) |
0.03 |
| Re-transplant
2 3 |
5 (4.1%)
1 (0.8%) |
10 (13.5%)
3 (4.1%) |
0.75 |
| DD
LRD LURD |
45 (36.6%)
60 (48.8%) 18 (14.6%) |
28 (37.8%)
30 (40.5%) 16 (21.6%) |
0.37 |
| Donor age | 33.2 ± 11.6 | 31.1 ± 9.5 | 0.2 |
| Thymoglobulin Induction
MMF AZA FK CSA |
123 (100%)
117 (95.1%) 6 (4.9%) 61 (49.6%) 62 (50.4%) |
74 (100%)
25 (33.8%) 49 (66.2%) 22 (29.7%) 52 (70.3%) |
1
<0.001 <0.001 0.006 0.006 |
| Pre-transplant dialysis | 86 (69.9%) | 54 (80%) | 0.65 |
| Deaths* | 14 (11.4%) | 11 (14.9%) | 0.5* |
| Failed graft** | 19 (15.4%) | 16 (21.6%) | 0.27** |
| Re-hospitalization | 95 (77.2%) | 61 (82.4%) | 0.38 |
| Time to re-hosp from Tx discharge | 65 ± 77.2 | 45.9 ± 65.4 | 0.1 |
| First re-admit length of stay | 4.2 ± 4.7 | 4.6 ± 5.9 | 0.56 |
| Number of re-hosp in first year:
1-3 4-6 >6 |
71 (57.7%)
18 (14.6%) 6 (4.9%) |
40 (54.1%)
15 (20.3%) 6 (8.1%) |
0.11 |
Infections were more often the cause for re-admission in steroid-inclusive protocols (p 0.0003). Steroid-avoidance immunosuppression does not reduce re-hospitalization rates in pediatric kidney transplant recipients.
CITATION INFORMATION: Verghese P., Chinnakotla S., Berglund D., Matas A., Chavers B. Re-Hospitalization after Pediatric Kidney Transplantation in Steroid Avoidance Protocols Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Verghese P, Chinnakotla S, Berglund D, Matas A, Chavers B. Re-Hospitalization after Pediatric Kidney Transplantation in Steroid Avoidance Protocols [abstract]. https://atcmeetingabstracts.com/abstract/re-hospitalization-after-pediatric-kidney-transplantation-in-steroid-avoidance-protocols/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress