Mortality in pediatric renal transplantation: a study of the French pediatric kidney database

Pediatr Transplant. 2009 Sep;13(6):725-30. doi: 10.1111/j.1399-3046.2009.01036.x.

Abstract

Objective and methods: To assess patient survival in pediatric renal transplantation, we retrospectively reviewed 573 transplants in 553 patients, registered from 1995 to 2005.

Results: Mean age at transplantation was 9.9 years. Patient survival at 1, 5 and 10 years was respectively 99%, 97% and 96%. Death occurred at a median time of 2.6 years after transplantation. Long-term patient survival was significantly lower in recipients younger than 5 years old. Seventeen patients (3.1%) died. Two deaths occurred while under maintenance dialysis. Among the remaining patients, the two main causes of death were infections (33%) and malignancies (27%). Interestingly, initial disease-related complications were a major cause of death (34%).

Conclusion: A low mortality rate was observed, with the majority of deaths due to malignancies and infections, and with a notable participation of complications related to the initial disease. No impact of cardiovascular disease was noted with the given follow-up period. Improvements in managing immunosuppression may contribute to reducing mortality in pediatric renal transplantation.

MeSH terms

  • Child
  • Child, Preschool
  • Databases, Factual
  • France
  • Graft Rejection / mortality*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney Diseases / mortality*
  • Kidney Diseases / surgery
  • Kidney Diseases / therapy*
  • Kidney Transplantation / adverse effects
  • Kidney Transplantation / methods*
  • Registries
  • Renal Dialysis
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Immunosuppressive Agents