title: Prevalence and outcomes of renal transplantation in children with intellectual disability.
abstract: To describe the prevalence and outcomes of renal transplantation in children with ID we performed a retrospective cohort analysis of all children receiving a first kidney-alone transplant in the UNOS dataset from 2008 to 2011. Recipients with definite, probable, and without ID were compared using chi-square tests. Kaplan-Meier curves were constructed for patient and graft survival. Cox proportional hazard models were used to estimate the association between ID and graft failure and patient survival. Over the study period, 332 children with definite (117) or probable (215) ID underwent first renal transplant, accounting for 16% of all first pediatric renal transplants (n = 2076). Children with definite ID were not significantly different from children without ID with respect to sex, ethnicity, or prevalence of acute rejection. ID was associated with increased likelihood of deceased donor source. ID was not significantly associated with decreased graft or patient survival. In this first large-scale study, up to 16% of first pediatric renal transplants were performed in children with ID. Short-term graft and patient survival after transplant were equivalent between children with and without ID. Further research is needed to examine long-term outcomes of transplant in this population.
authors.affiliation: Division of Nephrology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Wightman
authors.forename: Bessie
authors.initials: B
authors.lastname: Young
authors.forename: Miranda
authors.initials: M
authors.lastname: Bradford
authors.forename: André
authors.initials: A
authors.lastname: Dick
authors.forename: Patrick
authors.initials: P
authors.lastname: Healey
authors.forename: Ruth
authors.initials: R
authors.lastname: McDonald
authors.forename: Jodi
authors.initials: J
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D008607:Intellectual Disability / Q000150:complications* / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation; D008297:Male; D015995:Prevalence; D016016:Proportional Hazards Models; D051437:Renal Insufficiency / Q000150:complications* / Q000453:epidemiology / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: ethics; intellectual disability; nephrology; outcomes; renal transplant