TY - JOUR
T1 - Improved Outcomes of Kidney Transplantation in Infants (Age < 2 years)
T2 - A Single-Center Experience
AU - Chavers, Blanche M.
AU - Rheault, Michelle N.
AU - Matas, Arthur J.
AU - Jackson, Scott C.
AU - Cook, Marie E.
AU - Nevins, Thomas E.
AU - Najarian, John S.
AU - Chinnakotla, Srinath
N1 - Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Background Infants (age, < 2 years) with end-stage renal disease (ESRD) have increased morbidity and mortality. We evaluated our long-Term outcomes of kidney transplants (KTx) in infants. Methods Between 1984 and 2014, 136 infants underwent KTx. We examined trends in survival rates and complications by era (1984-1993 [era 1], 1994-2003 [era 2], 2004-2014 [era 3]). Results Patients were 92.6% white and 70.6% males. Posttransplant (Tx) initial length of hospital stay declined 37% over the 30-year period (P <0.01). Ten-year death-censored graft survival improved from 60% (era 1) to 80% (era 2) (P = 0.04). The incidence of acute rejection, graft thrombosis, cytomegalovirus, and urine leaks did not significantly change across eras. Frequency of Epstein-Barr virus diagnosis (era 2 vs era 3, P < 0.01) increased. Post-Tx lymphoproliferative disorder incidence was increased in era 2 compared with eras 1 and 3 (P = 0.03). Conclusions Infants deserve earlier consideration for KTx. Length of initial hospital stay and patient and graft survival rates after KTx have improved in infants since 1984.
AB - Background Infants (age, < 2 years) with end-stage renal disease (ESRD) have increased morbidity and mortality. We evaluated our long-Term outcomes of kidney transplants (KTx) in infants. Methods Between 1984 and 2014, 136 infants underwent KTx. We examined trends in survival rates and complications by era (1984-1993 [era 1], 1994-2003 [era 2], 2004-2014 [era 3]). Results Patients were 92.6% white and 70.6% males. Posttransplant (Tx) initial length of hospital stay declined 37% over the 30-year period (P <0.01). Ten-year death-censored graft survival improved from 60% (era 1) to 80% (era 2) (P = 0.04). The incidence of acute rejection, graft thrombosis, cytomegalovirus, and urine leaks did not significantly change across eras. Frequency of Epstein-Barr virus diagnosis (era 2 vs era 3, P < 0.01) increased. Post-Tx lymphoproliferative disorder incidence was increased in era 2 compared with eras 1 and 3 (P = 0.03). Conclusions Infants deserve earlier consideration for KTx. Length of initial hospital stay and patient and graft survival rates after KTx have improved in infants since 1984.
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U2 - 10.1097/TP.0000000000001929
DO - 10.1097/TP.0000000000001929
M3 - Article
C2 - 28846558
AN - SCOPUS:85041609013
SN - 0041-1337
VL - 102
SP - 284
EP - 290
JO - Transplantation
JF - Transplantation
IS - 2
ER -