Latin American Registry of Pediatric Renal Transplantation 2004-2008

Abstract

The Latin American Pediatric Nephrology Association (ALANEPE) reports the first regional kidney transplant registry in Latin America. A mean range of 75%, 30% to 100% renal transplant recipients under 21 yr old were included. Out of 20 countries invited to participate, 14 performed renal transplant, 11 had universal financial support from their governments. The centers included: Brazil (9), Argentina (4), Chile (4), Venezuela (3), Mexico (2), and one in: Cuba, Colombia, Costa Rica, Nicaragua, Guatemala, Ecuador, Honduras, Paraguay and Peru. The registry included 1458 patients, average of 291 per year, 55% male. Mean follow-up 23.4+/-17 months; mean age was 11.7+/-4.3 yr (1-21), 11% under five yr of age.

Etiology: uropathy/ reflux nephropathy 27%, glomerulopathies 24% (included 12% FSGS), hypo/dysplasia (11%), vascular (6%), congenital/hereditary (5%), unknown (19%). Induction therapy: 71% anti-IL2RAb, 13% ATG/TIMO, 14% non-induction. Maintenance therapy: Tacrolimus 64%, Cyclosporine 32%, MMF 54%, MPS 20%, noTORi 96%, steroids 90%, withdrawal or steroid avoidance 10%. Loss of graft 155/1458 (11%), death with functioning graft (3.4%), vascular thrombosis (2.8%), acute rejection (2.8%), recurrence of disease (1%). Forty-eight patients died (3.3%); infection was the main cause 23 (2.1%). Global patient survival rate at one, three, and five yr was 97%, 96%, and 96%. Graft survival rate at one, three, and five yr LRD was 96%, 93% and 89%; for DD 92%, 86% and 76% respectively. Both survival rates were higher in LRD (p<0.008 and p<0.001). A pediatric renal transplant study has started, making information available to be shared between the centers and the world.