METHODS: We describe the characteristics and outcomes of pediatric KPD recipients with comparison to pediatric non-KPD living donor kidney transplants (LDKT), pediatric LDKT recipients, and pediatric deceased donor (DDKT) recipients.
RESULTS: Our study cohort includes 4987 pediatric DDKTs, 3447 pediatric non-KPD LDKTs, and 258 pediatric KPD transplants. Fewer centers conducted at least one pediatric KPD procedure compared to those that conducted at least one pediatric LDKT or DDKT procedure (67, 136, and 155 centers, respectively). Five centers performed 31% of the pediatric KPD transplants. After adjustment, there were no differences in graft failure or mortality comparing KPD recipients to non-KPD LDKT, LDKT, or DDKT recipients.
CONCLUSIONS: We did not observe differences in transplant outcomes comparing pediatric KPD recipients to controls. Considering these results, KPD may be underutilized for pediatric recipients. Pediatric KT centers should consider including KPD in KT candidate education. Further research will be necessary to develop tools that could aid clinicians and families considering the time horizon for future KT procedures, candidate disease and histocompatibility characteristics, and other factors including logistics and donor protections.
方法:我们描述了儿童KPD受者的特征和结果,与儿童非KPD活体肾移植(LDKT)相比,小儿LDKT接受者,和儿科死亡供体(DDKT)接受者。
结果:我们的研究队列包括4987名儿科DDKT,3447儿科非KPDLDKTs,和258例小儿KPD移植。与进行至少一种小儿LDKT或DDKT手术的中心相比,进行至少一种小儿KPD手术的中心较少(67、136和155个中心,分别)。五个中心进行了31%的小儿KPD移植。调整后,KPD受者与非KPDLDKT相比,移植物衰竭或死亡率没有差异,LDKT,或DDKT收件人。
结论:我们没有观察到儿童KPD受者与对照组移植结果的差异。考虑到这些结果,儿童接受者可能未充分利用KPD。儿科KT中心应考虑将KPD纳入KT候选教育。进一步的研究将是必要的开发工具,可以帮助临床医生和家庭考虑未来的KT程序的时间范围,候选疾病和组织相容性特征,以及其他因素,包括后勤和捐助者保护。