Good outcome of kidney transplants in recipients of young donors: a NAPRTCS data analysis.

Publication Type
Journal Article
Year of Publication
Moudgil, Asha; Martz, Karen; Stablein, Donald M; Puliyanda, Dechu P
Pediatr Transplant
Date Published
2011 Mar
Adolescent; Adult; Age Factors; Chi-Square Distribution; Child; Disease-Free Survival; Female; Follow-Up Studies; Glomerular filtration rate; Graft Rejection; Graft Survival; Humans; Kaplan-Meier Estimate; Kidney Function Tests; kidney transplantation; Living Donors; Male; Middle Aged; pediatrics; Postoperative Care; Registries; Retrospective Studies; Statistics, Nonparametric; Survival Analysis; Tissue Donors; Treatment Outcome; United States; Young Adult

NAPRTCS data were analyzed to assess outcome of TX recipients from YDs (<5 yr) in comparison with IDs (6-35 yr) and ODs (36-55 yr). Of 9854 TX in NAPRTCS (1987-2003), 469 were YD. Patient survival (PS) and graft survival (GS) were compared between DD TX after 1995; 81YD, 1324 ID, and 429 OD and eGFR were compared among functioning grafts (YD 31, ID 439, OD 174) at three yr. PS was comparable in all groups; GS at one, two, and three yr in TX of YD (91.1%, 83.8%, 79.7%), ID (93.5%, 89.7%, 83.6%), and OD (92.2%, 87.2%, 82.4%) was comparable. The eGFR in YD was comparable to ID but better than OD (86.5 vs. 79.7 vs. 67.2 mL/min/1.73 m2, p 0.139 and<0.0003). Primary graft non-function was more frequent in TX from YD than ID and OD (3.7% vs. 0.3 and 0.7%, p=0.004); the incidence of vascular thrombosis was similar. The aforementioned data show that pediatric recipients of YD had equivalent patient and graft survival. Although primary graft non-function was higher, eGFR of functioning grafts was comparable to ID. With further improvements in care, kidneys from YD may present a viable option for transplantation.