The impact of changing practice on improved outcomes of paediatric renal transplantation in the United Kingdom: a 25 years review

Transplant International : Official Journal of the European Society for Organ Transplantation
Lisa MumfordJane Tizard

Abstract

This review reports the outcomes of paediatric renal transplantation in the United Kingdom over the last 25 years. UK Transplant Registry data on 3236 paediatric renal transplants performed between 1 January 1992 and 31 December 2016 were analysed. Significant improvements in human leucocyte antigen (HLA) matching have been achieved; 84% of recipients received 000 or favourable (0 DR and 0 or 1 B) mismatched kidneys in 2016 compared with 27% in 1992. The median waiting time has increased from 126 days in 1999 to 351 days in 2016. Tacrolimus replaced ciclosporin in most immunosuppressive regimens after 2002. Renal transplant outcome has improved significantly, mainly because of a reduction in early graft loss. One-year donation after brain death renal allograft survival for those transplanted from 2012 to 2016 was 98%, compared with 72% for those transplanted from 1987 to 1991. Renal allograft survival for first kidney only transplants at 1, 5, 10, 20 and 25 years were 89%, 79%, 65%, 42% and 33% respectively. Superior survival with living donor was maintained throughout the study period with 25-year graft survival at 33% compared with 31% from deceased donor (P < 0.0001). Changes in immunosuppression regimens, improvements in HL...Continue Reading

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Citations

Apr 24, 2019·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Denis GlotzUNKNOWN C10-002 Study Group
Nov 2, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Chris J Callaghan, Stephen D Marks
Sep 26, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Felicia U EkeSeyi Oniyangi
Sep 16, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Qian ShenHong Xu
Jan 19, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Miriam DavidovitsEytan Mor
Feb 10, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·James McCaffrey, Mohan Shenoy
Apr 8, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·James McCaffreyMohan Shenoy
May 14, 2021·Clinical Journal of the American Society of Nephrology : CJASN·Hilda E Fernandez, Bethany J Foster

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