ESPN 50th Annual Meeting

ESPN 2017


 
RELATIONSHIP BETWEEN RECIPIENT’S AGE AT TRANSPLANT AND CHANGE OF ESTIMATED GLOMERULAR FILTRATION RATE AFTER PEDIATRIC KIDNEY TRANSPLANTATION
Junya Hashimoto 1 Yuko Hamsaki 1 Mai Kubota 1 Yusuke Takahashi 1 Yoshihiro Itabashi 2 Masaki Muramatsu 2 Takeshi Kawamura 2 Ken Sakai 2 Seiichiro Shishido 1

1- Department of Pediatric Nephrology, Toho University Faculty of Medicine, Tokyo, Japan.
2- Department of Nephrology, Toho University Faculty of Medicine, Tokyo, Japan.
 
Introduction:

In Japan, generally donors for pediatric kidney transplantation are adults, and have mismatch of body size with the recipients. However, the impact of recipient’s age on transplant outcomes remains unclear. We investigated short-term outcome of estimated glomerular filtration rate (e GFR) in children after kidney transplantation based on their age at transplant.

Material and methods:

We retrospectively reviewed the charts of pediatric living donor kidney transplant recipients who were transplanted adult kidney in our department from March 2009 to October 2014. Forty two recipients were followed over two years. These recipients were divided into 3 groups based on the age at transplant: Low (2-5 years, N=22), median (6-10 years, N=19), and high (11-15 years, N=18) age group. We compared the median eGFR of each age group at 1 month (P1), 4 months (P2), 12 months (P3), and 24 months (P4) after transplantation. The mean age and eGFR of donors at transplant were 41.5±7.9 years and 79.7±15.2 ml/min/1.73 m2, respectively.

Results:

 eGFR was calculated using a creatinine-based equation for Japanese children and adolescents aged 2-18 years. The changes of eGFR (ml/min/1.73 m2) in each age group were shown as follows:

Low (P1, P2, P3, P4): 92.3±18.9, 78.1±18.6, 69.7±16.8, 68.1±17.3

Median: 84.0±16.5, 72.7±13.9, 67.0±13.0, 64.6±12.5

High: 77.0±18.7, 67.7±16.1, 64.2±16.0, 64.1±14.4

The changes of eGFR between points were examined by paired t-test.

Low: P1-P2 (P0.01), P2-P3 (P0.01), P3-P4 (P0.51)

Median: P1-P2 (P0.01), P2-P3 (P0.01), P3-P4 (P0.38)

High: P1-P2(P0.01), P2-P3(P0.125), P3-P4(P0.97)

Conclusions:

In the first two years after pediatric kidney transplantation, eGFR of the recipients deteriorated over time regardless of age. Furthermore, the slope of eGFR decline tended to be larger in younger age group and earlier period of post-transplant.