Favorable Outcome After Single-kidney Transplantation From Small Donors in Children: A Match-controlled CERTAIN Registry Study
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Favorable Outcome After Single-kidney Transplantation From Small Donors in Children: A Match-controlled CERTAIN Registry Study. / Schild, Raphael; Carvajal Abreu, Karla; Büscher, Anja; Kanzelmeyer, Nele; Lezius, Susanne; Krupka, Kai; Weitz, Marcus; Prytula, Agnieszka; Printza, Nikoleta; Berta, László; Saygılı, Seha Kamil; Sellier-Leclerc, Anne-Laure; Spartà, Giuseppina; Marks, Stephen D; König, Sabine; Topaloglu, Rezan; Klaus, Günter; Weber, Stefanie; Oh, Jun; Herden, Uta; Carraro, Andrea; Dello Strologo, Luca; Ariceta, Gema; Hoyer, Peter; Tönshoff, Burkhard; Pape, Lars.
in: TRANSPLANTATION, Jahrgang 108, Nr. 8, 01.08.2024, S. 1793-1801.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Favorable Outcome After Single-kidney Transplantation From Small Donors in Children: A Match-controlled CERTAIN Registry Study
AU - Schild, Raphael
AU - Carvajal Abreu, Karla
AU - Büscher, Anja
AU - Kanzelmeyer, Nele
AU - Lezius, Susanne
AU - Krupka, Kai
AU - Weitz, Marcus
AU - Prytula, Agnieszka
AU - Printza, Nikoleta
AU - Berta, László
AU - Saygılı, Seha Kamil
AU - Sellier-Leclerc, Anne-Laure
AU - Spartà, Giuseppina
AU - Marks, Stephen D
AU - König, Sabine
AU - Topaloglu, Rezan
AU - Klaus, Günter
AU - Weber, Stefanie
AU - Oh, Jun
AU - Herden, Uta
AU - Carraro, Andrea
AU - Dello Strologo, Luca
AU - Ariceta, Gema
AU - Hoyer, Peter
AU - Tönshoff, Burkhard
AU - Pape, Lars
N1 - Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2024/8/1
Y1 - 2024/8/1
N2 - BACKGROUND: Kidney transplantation (KTx) from small donors is associated with inferior graft survival in registry studies, whereas single-center studies show favorable results.METHODS: We compared 175 pediatric KTx from small donors ≤20 kg (SDKTx) with 170 age-matched recipients from adult donors (ADKTx) from 20 centers within the Cooperative European Paediatric Renal Transplant Initiative registry. Graft survival and estimated glomerular filtration rate (eGFR) were analyzed by Cox regression and mixed models. Detailed data on surgical and medical management were tested for association with graft survival.RESULTS: One-year graft survival was lower after SDKTx compared with ADKTx (90.9% versus 96.5%; odds ratio of graft loss, 2.92; 95% confidence interval [CI], 1.10-7.80; P = 0.032), but 5-y graft survival was comparable (90.9% versus 92.7%; adjusted hazard ratio of graft loss 1.9; 95% CI, 0.85-4.25; P = 0.119). SDKTx recipients had an annual eGFR increase of 8.7 ± 6.2 mL/min/1.73 m² compared with a decrease of 6.9 ± 5.7 mL/min/1.73 m² in ADKTx recipients resulting in a superior 5-y eGFR (80.5 ± 25.5 in SDKTx versus 65.7 ± 23.1 mL/min/1.73 m² in ADKTx; P = 0.008). At 3 y posttransplant, eGFR after single SDKTx was lower than after en bloc SDKTx (86.6 ± 20.4 versus 104.6 ± 35.9; P = 0.043) but superior to ADKTx (68.1 ± 23.9 mL/min/1.73 m²). Single-kidney SDKTx recipients had a lower rate of hypertension at 3 y than ADKTx recipients (40.0% versus 64.7%; P = 0.008).CONCLUSIONS: Compared with ADKTx, 5-y graft function is superior in SDKTx and graft survival is similar, even when performed as single KTx. Utilizing small donor organs, preferably as single kidneys in experienced centers, is a viable option to increase the donor pool for pediatric recipients.
AB - BACKGROUND: Kidney transplantation (KTx) from small donors is associated with inferior graft survival in registry studies, whereas single-center studies show favorable results.METHODS: We compared 175 pediatric KTx from small donors ≤20 kg (SDKTx) with 170 age-matched recipients from adult donors (ADKTx) from 20 centers within the Cooperative European Paediatric Renal Transplant Initiative registry. Graft survival and estimated glomerular filtration rate (eGFR) were analyzed by Cox regression and mixed models. Detailed data on surgical and medical management were tested for association with graft survival.RESULTS: One-year graft survival was lower after SDKTx compared with ADKTx (90.9% versus 96.5%; odds ratio of graft loss, 2.92; 95% confidence interval [CI], 1.10-7.80; P = 0.032), but 5-y graft survival was comparable (90.9% versus 92.7%; adjusted hazard ratio of graft loss 1.9; 95% CI, 0.85-4.25; P = 0.119). SDKTx recipients had an annual eGFR increase of 8.7 ± 6.2 mL/min/1.73 m² compared with a decrease of 6.9 ± 5.7 mL/min/1.73 m² in ADKTx recipients resulting in a superior 5-y eGFR (80.5 ± 25.5 in SDKTx versus 65.7 ± 23.1 mL/min/1.73 m² in ADKTx; P = 0.008). At 3 y posttransplant, eGFR after single SDKTx was lower than after en bloc SDKTx (86.6 ± 20.4 versus 104.6 ± 35.9; P = 0.043) but superior to ADKTx (68.1 ± 23.9 mL/min/1.73 m²). Single-kidney SDKTx recipients had a lower rate of hypertension at 3 y than ADKTx recipients (40.0% versus 64.7%; P = 0.008).CONCLUSIONS: Compared with ADKTx, 5-y graft function is superior in SDKTx and graft survival is similar, even when performed as single KTx. Utilizing small donor organs, preferably as single kidneys in experienced centers, is a viable option to increase the donor pool for pediatric recipients.
U2 - 10.1097/TP.0000000000004993
DO - 10.1097/TP.0000000000004993
M3 - SCORING: Journal article
C2 - 38685197
VL - 108
SP - 1793
EP - 1801
JO - TRANSPLANTATION
JF - TRANSPLANTATION
SN - 0041-1337
IS - 8
ER -
