ESPN 54th Annual Meeting

ESPN 2022


 
Kidney transplant outcomes in smaller children compared to larger children – report from the UK Transplant Registry
JAN DUDLEY 1 CHARLIE PICKLES 2 CHLOE BROWN 3 BEN REYNOLDS 4 NICOS KESSARIS 1 STEPHEN MARKS 5

1- BRISTOL ROYAL HOSPITAL FOR CHILDREN
2- GREAT NORTH CHILDRENS HOSPITAL, NEWCASTLE
3- NHS BLOOD AND TRANSPLANT
4- ROYAL HOSPITAL FOR CHILDREN, GLASGOW
5- GREAT ORMOND ST HOSPITAL FOR CHILDREN
 
Introduction:

Kidney transplantation in young children is often delayed due to technical feasibility and concerns about poorer outcomes. We compared 5 and 10 year graft outcomes in children weighing < 12Kg and < 15Kg, compared with larger children.  

Material and methods:

Data on all first paediatric (aged <18 years) kidney only transplants performed in the UK between 1 January 2006 and 31 December 2016 were extracted from the UK Transplant Registry (n = 1,352).  Donor, recipient and transplant characteristics were compared.  Thirty day, one-year and five-year patient and allograft survival were compared using the Kaplan-Meier method.

Results:

There was no evidence of a difference in 30-day or one-year kidney allograft survival (p = 0.57, p = 0.73 respectively). Five-year allograft survival for children < 15Kg was better than that for children ≥15kg (92.1% (95% CI: 87.2% - 95.2%) vs 87.0% (95% CI: 84.6% - 89.0%)) but this did not reach statistical significance (p = 0.1).  For children < 12Kg, a greater proportion of kidney transplants were from living donors compared with children ≥12kg (p = 0.005). There was no difference overall in renal allograft function between the groups (p = 0.78).  Immediate graft function was seen in 77.9% of children <12Kg, compared with 84.5% in children ≥12kg, however, risk-adjusted analysis could not be performed due to the very small number of graft failures in this group.

Conclusions:

Patient and renal allograft survival outcomes for kidney transplantation undertaken in small children are at least as good as for larger children and this should be reflected in earlier preparation for transplantation for these children. 10-year graft survival data are currently being analysed