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Long-Term Follow-Up after Paediatric Kidney Transplantation and Influence Factors on Graft Survival: A Single-Centre Experience of 16 years

Urol Int. 2018;100(3):317-321. doi: 10.1159/000487195. Epub 2018 Mar 7.

Abstract

Introduction: To evaluate graft- and patient survival after paediatric kidney transplantation and detecting influence factors, which affect the post-transplant time.

Materials and methods: We analysed long-term survival rates and complications after paediatric kidney transplantation and searched for predictive parameters for graft function.

Results: In 132 patients, 143 kidney transplantations were performed. Graft failure occurred in 25%. Chronic rejections were the leading cause of graft loss (42.9%). Graft survival rates were 92.2% after 1 year, 85.5% after 5 years, 71.1% after 10 years and 62.1% after 15 years. The following parameters strongly influenced graft survival: number of transplants (p = 0.014), year of transplant (p < 0.0001 for 1997-2005), Epo-therapy post-transplant (p = 0.001), hypotension donor (p = 0.027), cold ischemia time (p = 0.023), anastomosis time >50 min (p = 0.008), delayed graft function (p = 0.003) and deceased donation (p = 0.039). The percentage of patients who died was 5.6%. Overall patient survival rates were 99.3% after 1 year, 95.2% after 5 years, 94.2% after 10 years and 90.7% after 15 years. Various types of infections (42.9%) were the main causes of death.

Conclusions: The main causes of death after kidney transplantations in paediatric recipients are malignancy and infections. To avoid vascular complications especially in young recipients (<9 years), the cold ischemia time should be as short as possible.

Keywords: Influence factors; Paediatric transplantation; Vascular complications.

MeSH terms

  • Body Weight
  • Child
  • Child, Preschool
  • Cold Ischemia*
  • Delayed Graft Function
  • Female
  • Follow-Up Studies
  • Graft Rejection
  • Graft Survival*
  • Humans
  • Infant
  • Kidney / abnormalities
  • Kidney / pathology
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation*
  • Living Donors
  • Male
  • Organ Preservation
  • Pediatrics
  • Time Factors
  • Treatment Outcome