Volume 23, Issue 3 e13377
ORIGINAL ARTICLE

A comparison of post-transplant renal function in pre-emptive and post-dialysis pediatric kidney transplant recipients

Jin K. Kim

Corresponding Author

Jin K. Kim

Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada

Correspondence

Jin K. Kim, Division of Urology, Hospital for Sick Children, Toronto, ON, Canada.

Email: [email protected]

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Armando J. Lorenzo

Armando J. Lorenzo

Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada

Department of Surgery, University of Toronto, Toronto, Ontario, Canada

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Walid A. Farhat

Walid A. Farhat

Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada

Department of Surgery, University of Toronto, Toronto, Ontario, Canada

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Michael E. Chua

Michael E. Chua

Department of Surgery, University of Toronto, Toronto, Ontario, Canada

nstitute of Urology, St. Luke’s Medical Center, Quezon City, Philippines

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Jessica M. Ming

Jessica M. Ming

Department of Surgery, University of Toronto, Toronto, Ontario, Canada

Department of Surgery, University of New Mexico, Albuquerque, NM, USA

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Joana Dos Santos

Joana Dos Santos

Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada

Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada

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Martin A. Koyle

Martin A. Koyle

Division of Urology, The Hospital for Sick Children, Toronto, Ontario, Canada

Department of Surgery, University of Toronto, Toronto, Ontario, Canada

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First published: 08 February 2019
Citations: 8

Abstract

Purpose

Little is known regarding post-transplant renal function following pediatric pre-emptive KT. Therefore, this study aims to determine whether there is a difference in 1 year post-transplant renal function outcomes between pre-emptive and post-dialysis KT in pediatric transplant recipients.

Methods

A retrospective review of patients who underwent kidney transplant at our institution between 2000 and 2015 was performed. Kidney transplant recipients were divided into four groups: pre-DD, post-DD, pre-LD, and post-LD. The clinical outcomes, measured in eGFR (mL/min/1.73 m2), acute rejection episodes within 1 year, and hospitalization within 1 year were compared to between groups in their respective donor types (pre-DD vs post-DD; pre-LD vs post-LD).

Results

The 324 patients were identified (21 pre-DD, 151 post-DD, 54 pre-LD, and 98 post-LD). Post-DD group had more females (P = 0.018) and post-operative complications (P = 0.023), although there was no difference in complications requiring intervention (P = 0.129). Post-LD patients were more likely to be females (P = 0.017) and those with intrinsic renal (non-urological/structural) ESRD etiology (P = 0.003). The 1-year eGFR was similar between pre-DD and post-DD groups (70.3 [IQR 53.5-88.5] vs 74.3 [IQR 62.3-90.5], P = 0.613), as well as pre-LD and post-LD groups (66.6 [IQR 47.8-73.7] vs 63.9 [IQR 55.0-77.1], P = 0.600). There were no significant differences in rates of acute rejection episodes or hospitalization within 1 year of transplantation for in LD/DD groups.

Conclusion

There is no significant difference in renal function at 1 year post-transplant in pediatric patients receiving pre-emptive or post-dialysis kidney transplants.

CONFLICT OF INTEREST

All authors do not have potential conflict of interest to disclose.

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