Comparable Survival of En Bloc versus Standard Donor Kidney Transplants in Children

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• 作者：Erica Winnicki ; MD ; ^{ewinnicki@ucdavis.edu" class="auth_mail" title="E-mail the corresponding author} ; Madan Dharmar ; MBBS ; PhD ; Daniel Tancredi ; PhD ; Lavjay Butani ; MD
• 关键词：eGFR ; Estimated glomerular filtration rate ; HR ; Hazard ratio ; OPTN ; Organ Procurement and Transplantation Network ; PRA ; Panel reactive antibody
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：173
• 期：Complete
• 页码：169-174
• 全文大小：169 K

文摘

To determine whether renal transplantation survival is similar in children receiving pediatric en bloc kidneys compared with those receiving standard deceased donor kidneys.

Study design

We compared time to allograft failure and estimated glomerular filtration rate (eGFR) in pediatric recipients of en bloc and standard criteria deceased donor renal transplants using Organ Procurement and Transplantation Network data for 2000-2013. Cox regression analysis was used to compare time to allograft failure, and the Student t test was used to compare eGFR.

Results

A total of 6882 recipients met the study inclusion criteria; 1.8% received an en bloc transplant. The adjusted hazard for allograft failure was similar for recipients of en bloc kidneys compared with standard criteria kidneys (hazard ratio, 1.15; 95% CI, 0.83-1.59; P = .41). The median wait time for transplantation was significantly shorter for recipients of en bloc kidneys (157 days vs 208 days; P = .03). Moreover, eGFR was superior for recipients of en bloc kidneys up to 5 years post-transplantation.

Conclusion

Transplantation of en bloc pediatric kidneys should be considered a viable option for pediatric recipients and may afford unique benefits by reducing wait times and promoting preservation of graft function.