Chia-Shi Wang1,2, Larry A Greenbaum3,4, Rachel E Patzer5,6, Rouba Garro3,4, Barry Warshaw3,4, Roshan P George3,4, Pamela D Winterberg3,4, Kavita Patel3,7, Julien Hogan5,8. 1. Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA. chia-shi.wang@emory.edu. 2. Children's Healthcare of Atlanta, Atlanta, GA, USA. chia-shi.wang@emory.edu. 3. Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA. 4. Children's Healthcare of Atlanta, Atlanta, GA, USA. 5. Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA. 6. Department of Epidemiology, Emory Rollins School of Public Health, Atlanta, GA, USA. 7. Aflac Cancer and Blood Disorders, Children's Healthcare of Atlanta, Atlanta, GA, USA. 8. Pediatric Nephrology Department, Robert Debre Hospital, Assistance Publique-Hopitaux de Paris, Paris, France.
Abstract
BACKGROUND: Renal vascular thrombosis (RVT) is a major cause of early allograft loss in the first year following pediatric kidney transplantation. We examined recent trends in allograft loss due to RVT and identified associated risk factors. METHODS: We identified 14,640 kidney-only transplants performed between 1995 and 2014 with follow-up until June 30, 2016, in 13,758 pediatric patients aged < 19 years from the US Renal Data System. We examined the 1-year incidence of allograft loss due to RVT by year of transplant, and plotted the trend over time. Cox proportional hazards models were used to investigate the relationship between year of transplant as well as recipient, donor, and transplant characteristics with allograft loss due to RVT. RESULTS: The incidence of allograft loss due to RVT consistently declined among pediatric kidney transplant performed between 1995 and 2014. Among transplants performed between 1995 and 2004, 128/7542 (1.7%) allografts were lost due to RVT compared to 53/7098 (0.8%) among transplants performed between 2005 and 2014; average 1-year cumulative incidence was 1.5% (95% CI, 1.3-1.9%) and 0.6% (95% CI, 0.5-0.8%), respectively. Increased risk for allograft loss due to RVT was associated with en bloc kidney transplantation (HR, 3.42; 95% CI 1.38-8.43) and cold ischemia time ≥ 12 h (HR, 1.78; 95% CI, 1.15-2.76). Interestingly, these risk factors were more prevalent in the latter decade. CONCLUSIONS: The incidence of allograft loss due to RVT significantly and continuously declined among pediatric kidney transplants performed between 1995 and 2014. The causes for this improvement are unclear in the present analysis.
BACKGROUND:Renal vascular thrombosis (RVT) is a major cause of early allograft loss in the first year following pediatric kidney transplantation. We examined recent trends in allograft loss due to RVT and identified associated risk factors. METHODS: We identified 14,640 kidney-only transplants performed between 1995 and 2014 with follow-up until June 30, 2016, in 13,758 pediatric patients aged < 19 years from the US Renal Data System. We examined the 1-year incidence of allograft loss due to RVT by year of transplant, and plotted the trend over time. Cox proportional hazards models were used to investigate the relationship between year of transplant as well as recipient, donor, and transplant characteristics with allograft loss due to RVT. RESULTS: The incidence of allograft loss due to RVT consistently declined among pediatric kidney transplant performed between 1995 and 2014. Among transplants performed between 1995 and 2004, 128/7542 (1.7%) allografts were lost due to RVT compared to 53/7098 (0.8%) among transplants performed between 2005 and 2014; average 1-year cumulative incidence was 1.5% (95% CI, 1.3-1.9%) and 0.6% (95% CI, 0.5-0.8%), respectively. Increased risk for allograft loss due to RVT was associated with en bloc kidney transplantation (HR, 3.42; 95% CI 1.38-8.43) and cold ischemia time ≥ 12 h (HR, 1.78; 95% CI, 1.15-2.76). Interestingly, these risk factors were more prevalent in the latter decade. CONCLUSIONS: The incidence of allograft loss due to RVT significantly and continuously declined among pediatric kidney transplants performed between 1995 and 2014. The causes for this improvement are unclear in the present analysis.
Authors: A Hart; J M Smith; M A Skeans; S K Gustafson; A R Wilk; A Robinson; J L Wainright; C R Haynes; J J Snyder; B L Kasiske; A K Israni Journal: Am J Transplant Date: 2018-01 Impact factor: 8.086
Authors: H Ismail; P Kaliciński; T Drewniak; E Smirska; A Kamiński; A Prokurat; R Grenda; M Szymczak; M Chrupek; M Markiewicz Journal: Pediatr Transplant Date: 1997-08
Authors: Luciana de Santis Feltran; Camila Penteado Genzani; Fernando Hamamoto; Mariana Janiques Barcia Magalhaes Fonseca; Maria Fernanda Carvalho de Camargo; Nara Léia Gelle de Oliveira; Fabio Cabral de Freitas Amaral; Jose Carlos Baptista; Paulo Cesar Koch Nogueira Journal: Pediatr Nephrol Date: 2021-10-14 Impact factor: 3.714