title: Long-term outcome of pediatric renal transplantation: the Norwegian experience in three eras 1970-2006.
abstract: During the years 1970-2006, 251 renal transplantations were performed in 178 children in Norway. The proportion of LD was 84%. Transplantations were performed preemptively in 52%. Pretransplant dialysis time was median three months. Structural abnormalities and hereditary renal disorders constituted 69% of end-stage renal diseases, 29% were caused by glomerulopathies and other acquired disorders and 2% of unknown cause. Patient survival rates were 94.2, 93.5, and 84.4% at five, 10, and 20 yr, respectively. The most frequent cause of death was infections followed by cardiovascular events. For recipients of living donor grafts (n = 149), survival of first transplant was 82, 68.8, and 45.1% at five, 10, and 20 yr, respectively, and was significantly higher than for recipients of deceased donor organs (n = 29; log rank, p = 0.008). The only significant predictor for better transplant survival when modeled with multiple regression analysis adjusted for pretransplant dialysis, diagnosis, donor age, sex and immunosuppressive era, was the use of LD compared with DD (HR = 2.1, 95% CI [1.1-4.0], p = 0.02). The acute rejection rate declined significantly from 61.5% in 1970-1982 to 14.5% in 2000-2006 (log rank, p = 0.002). It remains to be seen whether the reduction in acute rejection rate and present immunosuppressive therapy will have a positive impact on long-term graft survival in years to come.
authors.affiliation: Division of Pediatrics, Section for Specialised Children's Medicine, Department of Medicine, Rikshopitalet, University Hospital, Oslo, Norway.
authors.forename: Trine
authors.initials: T
authors.lastname: Tangeraas
authors.forename: Anna
authors.initials: A
authors.lastname: Bjerre
authors.forename: Bjorn
authors.initials: B
authors.lastname: Lien
authors.forename: Anders
authors.initials: A
authors.lastname: Kyte
authors.forename: Eirik
authors.initials: E
authors.lastname: Monn
authors.forename: Milada
authors.initials: M
authors.lastname: Cvancarova
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Leivestad
authors.forename: Anna Varberg
authors.initials: AV
authors.lastname: Reisaeter
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D007223:Infant; D007674:Kidney Diseases / Q000453:epidemiology* / Q000628:therapy*; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D009664:Norway; D012044:Regression Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents