title: Outcomes and predictive factors of pediatric kidney transplants: an analysis of the Thai Transplant Registry.
abstract: As universal coverage for pediatric kidney transplantation (KT) was introduced in Thailand in 2008, the number of recipients has been increasing. We evaluated predictive factors for graft failure to understand how to improve clinical outcomes in these children. Using data obtained from the National Transplant registry, we assessed the risk of graft failure using the Kaplan-Meier method and Cox proportional hazards regression. Altogether, 201 recipients aged <21 yr at the time of KT were studied. Living donors (LD) were significantly older than deceased donor (DD). Mean cold ischemia time of DD was 17 h. The mean donor glomerular filtration rate (GFR) was 84.0 mL/min/1.73 m(2) . Induction immunosuppressive therapy was administered more frequently in DD than in LDKT. Delayed graft function (DGF) occurred in 36 transplants. Over 719 person years of follow-up, 42 graft failures occurred. Graft survival at one, three, and five yr post-transplant were 95%, 88% and 76%, respectively. Two factors independently predicted graft failure in multivariate analysis. The hazard ratios for graft failure in patients with DGF and in patients with donor GFR of ≤30 mL/min/1.73 m(2) were 2.5 and 9.7, respectively. Pediatric recipients should receive the first priority for allografts from young DD with a good GFR, and DGF should be meticulously prevented.
authors: Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. pornpimol.r@chula.ac.th
authors: Pornpimol
authors: P
authors: Rianthavorn
authors: Stephen J
authors: SJ
authors: Kerr
authors: Adisorn
authors: A
authors: Lumpaopong
authors: Apichat
authors: A
authors: Jiravuttipong
authors: Anirut
authors: A
authors: Pattaragarn
authors: Kanchana
authors: K
authors: Tangnararatchakit
authors: Yingyos
authors: Y
authors: Avihingsanon
authors: Prapaipim
authors: P
authors: Thirakupt
authors: Vasant
authors: V
authors: Sumethkul
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D051799:Delayed Graft Function / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D013785:Thailand; D014019:Tissue Donors / Q000706:statistics & numerical data; D016896:Treatment Outcome; D055815:Young Adult