title: Mortality after pediatric kidney transplantation in England--a population-based cohort study.
abstract: The aim of this study was to explore mortality after pediatric kidney transplantation in England over the last decade. We used data from HES to select all kidney transplant procedures performed in England between April 2001 and March 2012. Data linkage analysis was performed with the ONS to identify all deaths occurring among this study cohort. Data for 1189 pediatric recipients were compared to 17 914 adult recipients (number of deaths, 33 vs. 2052, respectively, p < 0.001), with median follow-up 4.4 yr (interquartile range 2.2-7.3 yr). There was no difference in mortality within the pediatric cohort; age 0-1 (n = 25, patient survival 100.0%), age 2-5 (n = 198, patient survival 96.0%), age 6-12 (n = 359, patient survival 97.5%), and age 13-18 (n = 607, patient survival 97.4%), respectively (p = 0.567). The most common causes of death were renal (n = 8, 24.2%), infection (n = 6, 18.2%), and malignancy (n = 5, 15.2%). All deaths from malignancy were secondary to PTLD. In a fully adjusted Cox regression model, only white ethnicity was significantly associated with risk of pediatric mortality post-kidney transplantation (hazard ratio 2.7, 95% confidence interval [1.0-7.3], p = 0.047). To conclude, this population-based cohort study confirms low mortality after pediatric kidney transplantation with short follow-up.
authors.affiliation: Department of Nephrology and Transplantation, Renal Institute of Birmingham, Queen Elizabeth Hospital, Birmingham, UK.
authors.forename: Daniela
authors.initials: D
authors.lastname: Farrugia
authors.forename: James
authors.initials: J
authors.lastname: Cheshire
authors.forename: Sophia
authors.initials: S
authors.lastname: Mahboob
authors.forename: Irena
authors.initials: I
authors.lastname: Begaj
authors.forename: Sajan
authors.initials: S
authors.lastname: Khosla
authors.forename: Daniel
authors.initials: D
authors.lastname: Ray
authors.forename: Adnan
authors.initials: A
authors.lastname: Sharif
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D004739:England; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016030:Kidney Transplantation; D008297:Male; D016016:Proportional Hazards Models; D012044:Regression Analysis; D051437:Renal Insufficiency / Q000208:ethnology / Q000401:mortality* / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: death; kidney transplantation; mortality; pediatric; survival