title: Collaborative Brazilian Pediatric Renal Transplant Registry (CoBrazPed-RTx): A Report From 2004 to 2013.
abstract: BACKGROUND
  The Collaborative Brazilian Pediatric Renal Transplant Registry started in 2004 as a multicenter initiative aiming to analyze, report, and share the results of pediatric kidney transplantation in Brazil. Data from all pediatric kidney transplants performed between January 2004 and December 2013 were recorded electronically and periodically updated. All patients under 18 years old from the participating centers were enrolled. Demographic data, etiology of chronic kidney disease, and patient and graft survival were analyzed. From a total of 2443 pediatric kidney transplants performed in Brazil during the study period, we report data from 1751 pediatric renal transplants performed in 13 centers enrolled in the collaborative study. Median age at transplantation was 12.4 years, and most of recipients were male (56%). The most common underlying renal etiologies were obstructive uropathy (31%) and glomerulopathy (26%).
  
  
  METHODS
  According to donor source, 1155 (66%) of transplants were performed with deceased donors (DD). Initial immunosuppression consisted mainly of tacrolimus, mycophenolate, steroids, and induction therapy with anti-IL-2R antibodies.
  
  
  RESULTS
  One-year graft survival (death-censored) was 93% and 90% (log rank test, P < .01), respectively, for living donor (LD) and DD. Graft losses (15%) were most frequently caused by vascular thrombosis, chronic allograft nephropathy, death with functioning kidney, acute rejection, and recurrent renal disease. Recipients of DD had 2.02 (95% confidence interval: 1.14-3.59) times the hazard of graft loss compared with those of LD (P = .015). Patient survival rates at 1 and 5 years were 98% and 97% for LD and 97% and 93% for DD, respectively. The mortality rate was 3.8%, mainly as the result of infection and cardiovascular disease.
  
  
  CONCLUSIONS
  The results of this collaborative pediatric transplant study are comparable to international registries. Our effort has been able to maintain an exchange of information, both among the participating centers and with other international registries.
authors.affiliation: Pediatric Nephrology Unit, Hospital da Criança Santo Antonio-Santa Casa, Universidade Ciencias da Saude Porto Alegre, Porto Alegre, Brazil. Electronic address: cdruckgarcia@gmail.com.
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authors.affiliation: Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil.
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authors.affiliation: Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil.
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authors.affiliation: Nephrology Division, Hospital do Rim, Universidade Federal de São Paulo, São Paulo, Brazil.
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authors.affiliation: Pediatric Nephrology Unit, Hospital da Criança Santo Antonio-Santa Casa, Universidade Ciencias da Saude Porto Alegre, Porto Alegre, Brazil.
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authors.affiliation: Pediatric Nephrology Unit, Hospital da Criança Santo Antonio-Santa Casa, Universidade Ciencias da Saude Porto Alegre, Porto Alegre, Brazil.
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authors.affiliation: Pediatric Nephrology Unit Hospital Samaritano São Paulo, São Paulo, Brazil.
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authors.affiliation: Pediatric Nephrology Unit Hospital Samaritano São Paulo, São Paulo, Brazil.
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authors.affiliation: Transplant Unit Hospital Geral de Fortaleza, Fortaleza, Brazil.
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authors.affiliation: Transplant Unit Hospital Geral de Fortaleza, Fortaleza, Brazil.
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authors.affiliation: Pediatric Nephrology Unit, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
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authors.affiliation: Pediatric Nephrology Unit Hospital Pequeno Príncipe, Curitiba, Brazil.
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authors.affiliation: Pediatric Nephrology Unit, Universidade Estadual de Campinas, Campinas, Brazil.
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authors.affiliation: Pediatric Nephrology Unit, Universidade Estadual de Campinas, Campinas, Brazil.
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authors.affiliation: Pediatric Nephrology Unit, Universidade Estadual de Campinas, Campinas, Brazil.
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authors.affiliation: Transplant Unit, Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil.
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authors.affiliation: Pediatric Nephrology Unit Santa Casa de São Paulo, São Paulo, Brazil.
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authors.affiliation: Transplant Unit Hospital de Base de São José do Rio Preto, S. J. Rio Preto, Brazil; Instituto Urologia Nefrologia São José Do Rio Preto, S. J. Rio Preto, Brazil.
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authors.affiliation: Pediatric Nephrology Unit, Hospital das Clinicas, UFMG, Belo Horizonte, Brazil.
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authors.affiliation: Programa de Pós graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Universidade de Caxias do Sul, Caxias do Sul, Brazil.
authors.forename: V
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authors.lastname: De Souza
authors.affiliation: Programa de Pós graduação em Saúde da Criança e do Adolescente, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D003299:Cooperative Behavior; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D016016:Proportional Hazards Models; D012008:Recurrence; D012042:Registries; D051436:Renal Insufficiency, Chronic; D015996:Survival Rate; D016559:Tacrolimus / Q000627:therapeutic use; D014019:Tissue Donors
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D016559:Tacrolimus