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Re-Hospitalization after Pediatric Kidney Transplantation in Steroid Avoidance Protocols

P. Verghese, S. Chinnakotla, D. Berglund, A. Matas, B. Chavers.

University of Minnesota, Minneapolis.

Meeting: 2018 American Transplant Congress

Abstract number: B239

Keywords: Kidney, Pediatric

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).

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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 May 9, 2025.

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