title: Effect of donor and recipient variables on the long-term live-donor renal allograft survival in children.
abstract: OBJECTIVE
  We aimed to analyse donor and recipient predictors of graft survival in children who received live-donor renal grafts.
  
  
  METHODS
  The study comprised 273 children who received live-donor renal transplants at our center between March 1976 and October 2010. The follow-up ranged from 6 months to 25 years. Donor variables included donor age, gender, donor/recipient body weight ratio (DR BWR), ABO blood groups, human leukocyte antigen, and DR mismatching. Donor-specific problems, e.g., ischemia time during surgery and number of renal arteries, were included. Recipient variables included recipient age, sex, original kidney disease, ischemia time, acute tubular necrosis (ATN) after transplantation, immunosuppression, number of acute rejection episodes, re-transplantation, and development of hypertension.
  
  
  RESULTS
  Independent variables with a sustained effect on the 5- and 10-year graft survival on multivariate analysis were: ATN after transplant, number of acute rejections, hypertension, and DR BWR. At the last follow-up, 185 patients (67.8%) had a functioning graft, while 82 (30.0%) had graft failure. Only six patients (0.02%) were lost to follow-up.
  
  
  CONCLUSIONS
  Donor and recipient variables that affect short- and long-term graft survival in children with a live-donor renal allograft are DR BWR, number of acute rejections, ATN and hypertension after transplant. Considering these variables provides a better outcome.
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Ehab W
authors.initials: EW
authors.lastname: Wafa
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Shokeir
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Akl
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Nabil
authors.initials: N
authors.lastname: Hassan
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Fouda
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Kalid
authors.initials: K
authors.lastname: El Dahshan
authors.affiliation: Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Ghoneim
keywords: ATN, acute tubular necrosis; BWR, body weight ratio; Children; DR, donor/recipient; ESKD, end-stage kidney disease; HLA, human leukocyte antigen; Kidney transplantation; Live donor; NAPRTCS, North American Pediatric Renal Transplant Cooperative Study; Outcome; UNOS, United Network for Organ Sharing