More than four decades of graft survival in pediatric kidney transplant recipients.

Autor: Kizilbash S; Division of Pediatric Nephrology, Department of Pediatrics, University of Minnesota, 2450 Riverside Ave, AOB 201, Minneapolis, MN, 55454, USA. kizil010@umn.edu., Rheault M; Division of Pediatric Nephrology, Department of Pediatrics, University of Minnesota, 2450 Riverside Ave, AOB 201, Minneapolis, MN, 55454, USA., Matas A; Department of Surgery, University of Minnesota, Minneapolis, MN, USA., Mauer M; Division of Pediatric Nephrology, Department of Pediatrics, University of Minnesota, 2450 Riverside Ave, AOB 201, Minneapolis, MN, 55454, USA., Nevins T; Division of Pediatric Nephrology, Department of Pediatrics, University of Minnesota, 2450 Riverside Ave, AOB 201, Minneapolis, MN, 55454, USA., Chavers B; Division of Pediatric Nephrology, Department of Pediatrics, University of Minnesota, 2450 Riverside Ave, AOB 201, Minneapolis, MN, 55454, USA.
Jazyk: angličtina
Zdroj: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2024 Feb; Vol. 39 (2), pp. 631-635. Date of Electronic Publication: 2023 Sep 19.
DOI: 10.1007/s00467-023-06153-z
Abstrakt: Background: Early in the history of kidney transplantation, short-term graft survival was low. Yet some have had excellent long-term survival. Herein, we describe characteristics of pediatric recipients with > 40 years of graft survival currently alive with a functioning first graft.
Methods: We reviewed all pediatric (age < 18 years) kidney transplants performed at the University of Minnesota between January 1, 1970, and December 31, 1979 (n = 148), to identify all recipients currently alive with a functioning first graft. Data are presented as medians with interquartile ranges (IQR) and proportions.
Results: We identified 10 recipients with > 40-year graft survival (median follow-up: 45.0 years (IQR: 43.1, 48.1)). The median age at transplant was 13.8 years (IQR: 5.1, 16.3). All recipients were white; half were male. Of the 10, 4 had glomerulonephritis, 2 had congenital anomalies of the kidney and the urinary tract, 2 had congenital nephrotic syndrome, 1 had Alport syndrome, and 1 had cystic kidney disease as kidney failure cause. Nine patients received a living-related donor transplant, and 1 patient received a deceased-donor transplant. The median estimated glomerular filtration rate at 20 years post-transplant was 79.9 (IQR: 72.3, 98.4); at 30 years, 67.7 (IQR: 63.2, 91.8); and at 40 years, 80.3 ml/min/1.73 m 2 (IQR: 73.7, 86.0). None developed rejection, 5 developed hypertension, 2 developed dyslipidemia, 1 developed diabetes, and 7 patients developed malignancy (4 skin cancer, 2 breast cancer, and 1 post-transplant lymphoproliferative disease).
Conclusion: Pediatric kidney transplant recipients may achieve > 4 decades of graft survival. Cancer is a common complication warranting vigilant screening.
(© 2023. The Author(s), under exclusive licence to International Pediatric Nephrology Association.)
Databáze: MEDLINE
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