Composite Health Outcomes in Pediatric and Young Adult Kidney Transplant Recipients.
J Pediatr
; 204: 196-202, 2019 01.
Article
em En
| MEDLINE
| ID: mdl-30274920
ABSTRACT
OBJECTIVE:
To assess composite health outcomes in pediatric and young adult kidney transplant recipients following kidney transplantation. STUDYDESIGN:
We conducted a cross-sectional study of all recipients at our center who had a 1-, 3-, 5-, and/or 10-year transplant anniversary visit between October 2008 and February 2015. The kidney transplant recipients were assessed at each time point according to an outcome measure consisting of 15 pass/fail criteria in 5 domains allograft health, rejection and immunology, infection, cardiovascular health, and growth.RESULTS:
We analyzed 148 patients at 231 transplantation anniversary visit time points; 52 of 82 (63%) patients assessed at 1 year had an ideal outcome, meeting at least 13 of the 15 criteria. This decreased to 37% at year 3, 40% at year 5, and 26% at year 10 (P < .01). The most common failures across all time points occurred in the domains of growth (43%-52% passing) and cardiovascular health (33%-51% passing). Allograft health declined significantly, decreasing from 74% at year 1 to 33% at year 10 (P < .01). The percentage of patients with graft failure increased from 2.4% at 1 year to 39.5% at 10 years (P < .01), and patient deaths increased from 0 to 11% (P < .01) in the same time frame.CONCLUSIONS:
Ideal outcomes for pediatric kidney transplant recipients decrease over time with growth, cardiovascular health, and allograft health as the primary failure modes. Understanding the composite health of young recipients will allow primary care providers and nephrologists alike to evaluate the overall health of kidney transplant recipients and focus clinical care on the most common sequelae.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Transplante de Rim
/
Rejeição de Enxerto
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article