Marcus Weitz1, Guido F Laube2, Maria Schmidt2, Kai Krupka3, Luisa Murer4, Dominik Müller5, Bernd Hoppe6, Anja Büscher7, Jens König8, Martin Pohl9, Therese Jungraithmayr10, Florian Thiel11, Heiko Billing12, Ryszard Grenda13, Jacek Rubik13, Michael M Kaabak14, Fatos Yalcinkaya15, Rezan Topaloglu16, Nicholas Webb17, Luca Dello Strologo18, Lars Pape19, Silvio Nadalin20, Burkhard Tönshoff3. 1. Paediatric Nephrology, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland. marcus.weitz@kispi.uzh.ch. 2. Paediatric Nephrology, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland. 3. Department of Paediatrics I, University Children's Hospital, Heidelberg, Germany. 4. Paediatric Nephrology Dialysis and Transplant Unit, Department of Woman's and Child's Health, Azienda Ospedaliera-University of Padova, Padova, Italy. 5. Paediatric Nephrology, Charité Campus Virchow Hospital, Berlin, Germany. 6. University Children's Hospital, Bonn, Germany. 7. University Children's Hospital, Essen, Germany. 8. University Children's Hospital, Münster, Germany. 9. Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center - University Freiburg, Faculty of Medicine, Freiburg, Germany. 10. Department of Paediatric Nephrology, Children's Hospital, Memmingen, Germany. 11. University Children's Hospital, Hamburg-Eppendorf, Germany. 12. Paediatrics I, University Children's Hospital, Tübingen, Germany. 13. Department of Nephrology, Kidney Transplantation and Arterial Hypertension, Children's Memorial Health Institute, Warsaw, Poland. 14. Boris Petrovsky National Research Centre of Surgery, Moscow, Russia. 15. Department of Paediatric Nephrology, Faculty of Medicine, Ankara University, Ankara, Turkey. 16. Department of Paediatric Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. 17. Department of Paediatric Nephrology and NIHR Manchester Clinical Research Facility, University of Manchester-Manchester Academic Health Science Centre, Manchester, UK. 18. Renal Transplantation Unit, Bambino Gesù Children's Hospital (OPBG), Institute for Scientific Research, Rome, Italy. 19. Department of Paediatric Nephrology, Hannover Medical School, Hannover, Germany. 20. Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany.
Abstract
BACKGROUND: Infants with a body weight of less than 10 kg are often not considered to be suitable candidates for renal transplantation (RTx). The objective of this study was to evaluate this arbitrary weight threshold for pediatric RTx. METHODS: We conducted a multicenter, retrospective, match-controlled cohort study on infants weighing less than 10 kg at time of engrafting (low-weight group [LWG], n = 38) compared to a matched control group (n = 76) with a body weight of 10-15 kg, using data from the first 2 years post-transplant derived from the CERTAIN Registry. RESULTS: Patient survival was 97 and 100% in the LWG and control groups, respectively (P = 0.33), and death-censored graft survival was 100 and 95% in the LWG and control groups, respectively (P = 0.30). Estimated glomerular filtration rate at 2 years post-transplant was excellent and comparable between the groups (LWG 77.6 ± 34.9 mL/min/1.73 m2; control 74.8 ± 29.1 mL/min/1.73 m2; P = 0.68). The overall incidences of surgery-related complications (LWG 11%, control 23%; P = 0.12) and medical outcome measures (LWG 23%, control 36%, P = 0.17) were not significantly different between the groups. The medical outcome measures included transplant-related viral diseases (LWG 10%, control 21%; P = 0.20), acute rejection episodes (LWG 14%, control 29%; P = 0.092), malignancies (LWG 3%, control 0%; P = 0.33) and arterial hypertension (LWG 73%, control 67%; P = 0.57). CONCLUSIONS: These data suggest that RTx in low-weight children is a feasible option, at least in selected centers with appropriate surgical and medical expertise.
BACKGROUND:Infants with a body weight of less than 10 kg are often not considered to be suitable candidates for renal transplantation (RTx). The objective of this study was to evaluate this arbitrary weight threshold for pediatric RTx. METHODS: We conducted a multicenter, retrospective, match-controlled cohort study on infants weighing less than 10 kg at time of engrafting (low-weight group [LWG], n = 38) compared to a matched control group (n = 76) with a body weight of 10-15 kg, using data from the first 2 years post-transplant derived from the CERTAIN Registry. RESULTS:Patient survival was 97 and 100% in the LWG and control groups, respectively (P = 0.33), and death-censored graft survival was 100 and 95% in the LWG and control groups, respectively (P = 0.30). Estimated glomerular filtration rate at 2 years post-transplant was excellent and comparable between the groups (LWG 77.6 ± 34.9 mL/min/1.73 m2; control 74.8 ± 29.1 mL/min/1.73 m2; P = 0.68). The overall incidences of surgery-related complications (LWG 11%, control 23%; P = 0.12) and medical outcome measures (LWG 23%, control 36%, P = 0.17) were not significantly different between the groups. The medical outcome measures included transplant-related viral diseases (LWG 10%, control 21%; P = 0.20), acute rejection episodes (LWG 14%, control 29%; P = 0.092), malignancies (LWG 3%, control 0%; P = 0.33) and arterial hypertension (LWG 73%, control 67%; P = 0.57). CONCLUSIONS: These data suggest that RTx in low-weight children is a feasible option, at least in selected centers with appropriate surgical and medical expertise.
Entities:
Keywords:
Children; Infants; Medical complications; Renal transplantation; Surgical complications
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