Academic Journal
Time-Varying Determinants of Graft Failure in Pediatric Kidney Transplantation in Europe
| العنوان: | Time-Varying Determinants of Graft Failure in Pediatric Kidney Transplantation in Europe |
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| المؤلفون: | Coens, Ferran, Knops, Noël, Tieken, Ineke, Vogelaar, Serge, Bender, Andreas, Kim, Jon Jin, Krupka, Kai, Pape, Lars, Raes, Ann, Tönshoff, Burkhard, Prytula, Agnieszka |
| المصدر: | Clinical Journal of the American Society of Nephrology ; volume 19, issue 3, page 345-354 ; ISSN 1555-9041 1555-905X |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health) |
| سنة النشر: | 2023 |
| الوصف: | Background Little is known about the time-varying determinants of kidney graft failure in children. Methods We performed a retrospective study of primary pediatric kidney transplant recipients (younger than 18 years) from the Eurotransplant registry (1990–2020). Piece-wise exponential additive mixed models were applied to analyze time-varying recipient, donor, and transplant risk factors. Primary outcome was death-censored graft failure. Results We report on 4528 kidney transplantations, of which 68% with deceased and 32% with living donor. One thousand six hundred and thirty-eight recipients experienced graft failure, and 168 died with a functioning graft. Between 2011 and 2020, the 5-year graft failure risk was 10% for deceased donor and 4% for living donor kidney transplant recipients. Risk of graft failure decreased five-fold from 1990 to 2020. The association between living donor transplantation and the lower risk of graft failure was strongest in the first month post-transplant (adjusted hazard ratio, 0.58; 95% confidence interval, 0.46 to 0.73) and remained statistically significant until 12 years post-transplant. Risk factors for graft failure in the first 2 years were deceased donor younger than 12 years or older than 46 years, potentially recurrent kidney disease, and panel-reactive antibody >0%. Other determinants of graft failure included dialysis before transplantation (until 5 years post-transplant), human leukocyte antigen mismatch 2–4 (0–15 years post-transplant), human leukocyte antigen mismatch 5–6 (2–12 years post-transplant), and hemodialysis (8–14 years post-transplant). Recipients older than 11 years at transplantation had a higher risk of graft failure 1–8 years post-transplant compared with other age groups, whereas young recipients had a lower risk throughout follow-up. Analysis of the combined effect of post-transplant time and recipient age showed a higher rate of graft failure during the first 5 years post-transplant in adolescents compared with young transplant recipients. In ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| DOI: | 10.2215/cjn.0000000000000370 |
| DOI: | 10.2215/CJN.0000000000000370 |
| الاتاحة: | http://dx.doi.org/10.2215/cjn.0000000000000370 https://journals.lww.com/10.2215/CJN.0000000000000370 |
| رقم الانضمام: | edsbas.6BF0EEE5 |
| قاعدة البيانات: | BASE |
| DOI: | 10.2215/cjn.0000000000000370 |
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