title: Good outcome of kidney transplants in recipients of young donors: a NAPRTCS data analysis.
abstract: 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.
authors.affiliation: Nephrology, Children National Medical Center, Washington, DC, USA. amoudgil@cnmc.org
authors.forename: Asha
authors.initials: A
authors.lastname: Moudgil
authors.forename: Karen
authors.initials: K
authors.lastname: Martz
authors.forename: Donald M
authors.initials: DM
authors.lastname: Stablein
authors.forename: Dechu P
authors.initials: DP
authors.lastname: Puliyanda
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016009:Chi-Square Distribution; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010372:Pediatrics; D011182:Postoperative Care / Q000379:methods; D012042:Registries; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D014019:Tissue Donors; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult