Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Aug;25(5):e13953.
doi: 10.1111/petr.13953. Epub 2020 Dec 22.

Late first acute rejection in pediatric kidney transplantation: A North American Pediatric Renal Trials and Collaborative Studies special study

Collaborators, Affiliations

Late first acute rejection in pediatric kidney transplantation: A North American Pediatric Renal Trials and Collaborative Studies special study

Kevin T Barton et al. Pediatr Transplant. 2021 Aug.

Abstract

Rates of early AR in pediatric kidney transplantation have declined in every era but the most recent NAPRTCS cohort has shown an increase in late first AR rates. We hypothesized this was due to an increased proportion of deceased donor utilization and early steroid taper utilization. Using the NAPRTCS database, we compared the most recent three cohorts of patients transplanted between 2002-2006, 2007-2011, and 2012-2017. To determine variables that predict late first AR, we used two multivariable models: a standard Cox regression model and LASSO model. From the LASSO model, deceased donor source (P = .002), higher recipient age (P = .019), black race (P = .010), and transplant cohort 2012-17 (P = .014) were all significant predictors of more late first AR. On standard Cox regression analysis, those same variables, minus donor source, were significant, in addition to mycophenolates usage (P = .007) and lower eGFR at 12 months (P = .02). The most recent 2012-2017 cohort remains an independently significant risk factor for late first AR, suggesting unmeasured variables. Further research is needed to determine whether these higher late first AR rates will impact long-term graft survival in the most recent cohort.

Keywords: acute rejection; outcome; pediatric; renal transplant.

PubMed Disclaimer

References

REFERENCES

    1. Chua A, Cramer C, Moudgil A, et al. Kidney transplant practice patterns and outcome benchmarks over 30 years: the 2018 report of the naprtcs. Pediatr Transplantat. 2019;23(8):e13597.
    1. Moudgil A, Dharnidharka VR, Lamb KE, Meier-Kriesche HU. Best allograft survival from share-35 kidney donors occurs in middle-aged adults and young children-an analysis of optn data. Transplantation. 2013;95(2):319-325.
    1. Israni AK, Salkowski N, Gustafson S, et al. New national allocation policy for deceased donor kidneys in the united states and possible effect on patient outcomes. J Am Soc Nephrol. 2014;25(8):1842-1848.
    1. Hart A, Smith JM, Skeans MA, et al. Optn/srtr 2015 annual data report: kidney. Am J Transplant. 2017;17(Suppl 1):21-116.
    1. Foster BJ, Dahhou M, Zhang X, Platt RW, Hanley JA. Relative importance of hla mismatch and donor age to graft survival in young kidney transplant recipients. Transplantation. 2013;96(5):469-475.

MeSH terms