Pediatric deceased donor kidney transplant outcomes under the Kidney Allocation System.
Am J Transplant
; 19(11): 3079-3086, 2019 11.
Article
em En
| MEDLINE
| ID: mdl-31062464
ABSTRACT
The Kidney Allocation System (KAS) has resulted in fewer pediatric kidneys being allocated to pediatric deceased donor kidney transplant (pDDKT) recipients. This had prompted concerns that post-pDDKT outcomes may worsen. To study this, we used SRTR data to compare the outcomes of 953 pre-KAS pDDKT (age <18 years) recipients (December 4, 2012-December 3, 2014) with the outcomes of 934 post-KAS pDDKT recipients (December 4, 2014-December 3, 2016). We analyzed mortality and graft loss by using Cox regression, delayed graft function (DGF) by using logistic regression, and length of stay (LOS) by using negative binomial regression. Post-KAS recipients had longer pretransplant dialysis times (median 1.26 vs 1.07 years, P = .02) and were more often cPRA 100% (2.0% vs 0.1%, P = .001). Post-KAS recipients had less graft loss than pre-KAS recipients (hazard ratio [HR] 0.35 0.540.83 , P = .005) but no statistically significant differences in mortality (HR 0.29 0.721.83 , P = .5), DGF (odds ratio 0.93 1.321.93 , P = .2), and LOS (LOS ratio 0.96 1.061.19 , P = .4). After adjusting for donor-recipient characteristics, there were no statistically significant post-KAS differences in mortality (adjusted HR 0.37 1.042.92 , P = .9), DGF (adjusted odds ratio 0.94 1.412.13 , P = .1), or LOS (adjusted LOS ratio 0.93 1.041.16 , P = .5). However, post-KAS pDDKT recipients still had less graft loss (adjusted HR 0.38 0.590.91 , P = .02). KAS has had a mixed effect on short-term posttransplant outcomes for pDDKT recipients, although our results are limited by only 2 years of posttransplant follow-up.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
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6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Doadores de Tecidos
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Obtenção de Tecidos e Órgãos
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Transplante de Rim
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Alocação de Recursos
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Função Retardada do Enxerto
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Rejeição de Enxerto
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Falência Renal Crônica
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Female
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Humans
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Male
Idioma:
En
Revista:
Am J Transplant
Ano de publicação:
2019
Tipo de documento:
Article