Mortality in pediatric renal transplantation: a study of the French pediatric kidney database.
OBJECTIVE
To assess patient survival in pediatric renal transplantation, we retrospectively reviewed 573 transplants in 553 patients, registered from 1995 to 2005.


RESULTS
Mean age at transplantation was 9.9 years. Patient survival at 1, 5 and 10 years was respectively 99%, 97% and 96%. Death occurred at a median time of 2.6 years after transplantation. Long-term patient survival was significantly lower in recipients younger than 5 years old. Seventeen patients (3.1%) died. Two deaths occurred while under maintenance dialysis. Among the remaining patients, the two main causes of death were infections (33%) and malignancies (27%). Interestingly, initial disease-related complications were a major cause of death (34%).


CONCLUSIONS
A low mortality rate was observed, with the majority of deaths due to malignancies and infections, and with a notable participation of complications related to the initial disease. No impact of cardiovascular disease was noted with the given follow-up period. Improvements in managing immunosuppression may contribute to reducing mortality in pediatric renal transplantation.
Allain-Launay
E
E
Pediatric Department, Centre Hospitalier et Universitaire, Nantes, France. emma.allainlaunay@chu-nantes.fr
Roussey-Kesler
G
G
Ranchin
B
B
Guest
G
G
Maisin
A
A
Novo
R
R
André
J L
JL
Cloarec
S
S
Guyot
C
C
D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005602:France; D006084:Graft Rejection / Q000401:mortality*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000401:mortality* / Q000601:surgery / Q000628:therapy*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D012042:Registries; D006435:Renal Dialysis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D007166:Immunosuppressive Agents