Severe intellectual disability is not a contraindication to kidney transplantation in children.
Renal transplantation in children with ID is controversial. Acceptability of these children as candidates varies between programs. Limited outcome data in pediatric renal TXP recipients with cognitive impairment diminish their access to TXP. A retrospective chart review was performed of all children who underwent renal transplantation between January 1, 2002 and June 30, 2012 (N=72). Patients were divided into two groups, those with ID prior to transplantation (n=10) and those without (non-ID; n=62). Graft survival and BPAR episodes were compared between the two groups using Kaplan-Meier estimates. Graft survival rates at 3 years post-TXP were 100% in the ID group and 80% in the non-ID group (P=.13). Rates of BPAR at 3 years post-TXP were 10% in the ID group and 27% in the non-ID group (P=.29). Graft survival and acute rejection-free survival rates are similar between children with ID and those without. Based on midterm outcomes, there is no apparent contraindication to renal transplantation in pediatric patients with ID. Children with ID should be considered as TXP candidates provided that they have an adequate social support network.
Department of Pediatrics, Wake Forest Baptist Health, Winston-Salem, NC, USA.
Ashton
A
Chen
Department of General Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA.
Alan
A
Farney
Department of Biostatistical Sciences, Wake Forest Baptist Health, Winston-Salem, NC, USA.
Gregory B
GB
Russell
Department of Pediatrics, Wake Forest Baptist Health, Winston-Salem, NC, USA.
Linda
L
Nicolotti
Department of General Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA.
Robert
R
Stratta
Department of General Surgery, Wake Forest Baptist Health, Winston-Salem, NC, USA.
Jeffrey
J
Rogers
Department of Pediatrics, Wake Forest Baptist Health, Winston-Salem, NC, USA.
Jen-Jar
JJ
Lin
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000075202:Contraindications; D006084:Graft Rejection; D006085:Graft Survival; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D008607:Intellectual Disability / Q000150:complications*; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation; D018579:Patient Selection; D051437:Renal Insufficiency / Q000150:complications* / Q000601:surgery*; D012189:Retrospective Studies; D012944:Social Support; D015996:Survival Rate; D016896:Treatment Outcome
disability; graft survival; kidney transplant