title: Age-Dependent Risk of Graft Failure in Young Kidney Transplant Recipients.
abstract: The risk of graft failure in young kidney transplant recipients has been found to increase during adolescence and early adulthood. However, this question has not been addressed outside the United States so far. Our objective was to investigate whether the hazard of graft failure also increases during this age period in France irrespective of age at transplantation.
  
  
  
  Data of all first kidney transplantation performed before 30 years of age between 1993 and 2012 were extracted from the French kidney transplant database. The hazard of graft failure was estimated at each current age using a 2-stage modelling approach that accounted for both age at transplantation and time since transplantation. Hazard ratios comparing the risk of graft failure during adolescence or early adulthood to other periods were estimated from time-dependent Cox models.
  
  
  
  A total of 5983 renal transplant recipients were included. The risk of graft failure was found to increase around the age of 13 years until the age of 21 years, and decrease thereafter. Results from the Cox model indicated that the hazard of graft failure during the age period 13 to 23 years was almost twice as high as than during the age period 0 to 12 years, and 25% higher than after 23 years.
  
  
  
  Among first kidney transplant recipients younger than 30 years in France, those currently in adolescence or early adulthood have the highest risk of graft failure.
authors.affiliation: 1 University of Bordeaux, ISPED, Centre INSERM U1219-Bordeaux Population Health Research, Bordeaux, France. 2 INSERM, ISPED, Centre INSERM U1219-Bordeaux Population Health Research, Bordeaux, France. 3 Agence de la Biomédecine, La Plaine-Saint Denis, France. 4 Pediatric Nephrology Unit, Robert Debré University Hospital, Paris, France. 5 Pediatric Nephrology Unit, Necker Enfants-Malades University Hospital, Paris, France. 6 Pediatric Nephrology Unit, Femme-Mère-Enfant Hospital, Lyon University Hospital, Lyon, France. 7 Pediatric Nephrology Unit, Jeanne de Flandre Hospital, Lille University Hospital, Lille, France. 8 Pediatric Nephrology Unit, Femme-Enfant-Adolescent Hospital, Nantes University Hospital, Nantes, France. 9 Pediatric Nephrology Unit, La Timone Hospital, Marseille University Hospital, Marseille, France. 10 Pediatric Nephrology Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France. 11 Pediatric Nephrology Unit, American Memorial Hospital, Reims University Hospital, Reims, France. 12 INSERM, Clinical Investigation Center, Clinical Epidemiology, Bordeaux, France. 13 Pediatric Nephrology Unit, Pellegrin-Enfants Hospital, Bordeaux University Hospital, Bordeaux, France.
authors.forename: Rémi
authors.initials: R
authors.lastname: Kaboré
authors.forename: Cécile
authors.initials: C
authors.lastname: Couchoud
authors.forename: Marie-Alice
authors.initials: MA
authors.lastname: Macher
authors.forename: Rémi
authors.initials: R
authors.lastname: Salomon
authors.forename: Bruno
authors.initials: B
authors.lastname: Ranchin
authors.forename: Annie
authors.initials: A
authors.lastname: Lahoche
authors.forename: Gwenaelle
authors.initials: G
authors.lastname: Roussey-Kesler
authors.forename: Florentine
authors.initials: F
authors.lastname: Garaix
authors.forename: Stéphane
authors.initials: S
authors.lastname: Decramer
authors.forename: Christine
authors.initials: C
authors.lastname: Pietrement
authors.forename: Mathilde
authors.initials: M
authors.lastname: Lassalle
authors.forename: Véronique
authors.initials: V
authors.lastname: Baudouin
authors.forename: Pierre
authors.initials: P
authors.lastname: Cochat
authors.forename: Patrick
authors.initials: P
authors.lastname: Niaudet
authors.forename: Pierre
authors.initials: P
authors.lastname: Joly
authors.forename: Karen
authors.initials: K
authors.lastname: Leffondré
authors.forename: Jérôme
authors.initials: J
authors.lastname: Harambat
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D017211:Treatment Failure; D055815:Young Adult