title: Trajectories and Predictors of Allograft Dysfunction after Renal Transplantation in Children.
abstract: The survival rates of renal transplant children are indeed on the rise, but it is still important to ensure that there is optimal renal function in these children in all their future growing years. The number of functioning nephrons and the graft ability to adapt to an increasing demand during body growth seem to be the most important factors for long-term allograft function. This study examined the long-term change in the glomerular filtration rate in a pediatric kidney transplant cohort and the importance of the recipient and donor ages in predicting transplant outcome.
  
  
  
  Data on 67 renal transplant children who underwent 278 inulin-clearance measurements between 2000 and 2010 were examined. A longitudinal latent class model was used to identify renal function trajectories and classify the children.
  
  
  
  This model identified 3 trajectories of renal allograft function after pediatric kidney transplantation: 'low and decreasing', 'moderate and stable', and 'high and sharply decreasing'. The probability of belonging to the low and decreasing trajectory - that is, the poorer outcome - was lower in recipients of grafts from living versus deceased donor (adjusted OR (aOR) 0.02; p = 0.03). This probability increased with recipient age (aOR 1.20 per year of recipient ageing; p = 0.07) and donor-recipient age-difference (aOR 1.13 per additional year; p = 0.07).
  
  
  
  This study suggests that donation from living donors and from younger donors are favorable factors for long-term allograft function.
authors.affiliation: Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Vandréa Carla
authors.initials: VC
authors.lastname: de Souza
authors.forename: Muriel
authors.initials: M
authors.lastname: Rabilloud
authors.forename: Pierre
authors.initials: P
authors.lastname: Cochat
authors.forename: Mario Bernardes
authors.initials: MB
authors.lastname: Wagner
authors.forename: Clotilde Druck
authors.initials: CD
authors.lastname: Garcia
authors.forename: Bruno
authors.initials: B
authors.lastname: Ranchin
authors.forename: Jean
authors.initials: J
authors.lastname: Iwaz
authors.forename: Luciano
authors.initials: L
authors.lastname: Selistre
authors.forename: Laurence
authors.initials: L
authors.lastname: Dubourg
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005602:France / Q000453:epidemiology; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000378:metabolism*; D051437:Renal Insufficiency / Q000453:epidemiology / Q000378:metabolism*; D012307:Risk Factors; D014019:Tissue Donors; D014564:Urogenital Abnormalities / Q000601:surgery*
chemical_list: D007166:Immunosuppressive Agents