International journal of nephrology · 2025
The Evolving Experience and Outcomes of Pediatric Kidney Transplant in Abu Dhabi, UAE (2010-2024).
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Beyyumi Ela, Al Dhaheri Watfa, Ahmad Niaz, Zaman Muhammad Badar, Khasawneh Eihab Al
Аннотация
BACKGROUND: Kidney transplant is acknowledged as the treatment of choice for end-stage renal disease (ESRD). This study reports on the outcome of pediatric renal transplant at a tertiary hospital in Abu Dhabi.
METHODS: It is a retrospective study of all pediatric renal transplants performed at a single designated pediatric center between February 2010 and February 2024, including children aged 1-16 years.
RESULTS: Sixty-nine (44% female) pediatric renal transplants were performed, 36 from living-related donors and 33 from deceased donors. The mean age at transplant and last follow-up were 9.8 ± 3.6 years and 13.8 ± 4.7 years, respectively. ESRD etiologies included congenital anomalies of the kidney and urinary tract (39%), nephronophthisis (19%), glomerulonephritis (13%), and other causes (29%). Thirteen (19%) children underwent a preemptive transplant, whereas 56 (81%) were on dialysis at transplant. Thirty-one (45%) children had graft rejection: 16 (23%) in the first year, 9 (13%) in years 2-5, and 6 (9%) thereafter. Donor-specific antibodies (DSAs) were detected in 19 (28%) children; 17 (25%) of those had graft rejection with anti-DR or anti-DQ alloantibodies. Fourteen children had DSA-negative graft rejection. Of those, eight had cell-mediated rejection, and six had mixed rejection. Predictors of rejection were positive DSA (p = < 0.0001) and two DR mismatches (p = 0.029); three graft losses occurred. The prevalence of EBV, CMV, and BKV infection in the first year was 43%, 39%, and 33%, respectively, falling to 38%, 18%, and 12% in the subsequent years. Thirty-four (49%) children had at least one episode of culture-positive urinary tract infection. The 1-year and 5-year patient survival rates were 100% and 96.6%, and the corresponding graft survival rates were 98.1% and 89.7%, respectively.
CONCLUSION: The outcome of pediatric kidney transplants in Abu Dhabi over 14 years shows patient and graft survival comparable to published data. Acute graft rejection remains a major challenge with the presence of DSA and biallelic HLA-DR mismatch as independent predictors for rejection. Optimizing donor selection, immunosuppression, and closer surveillance are vital.
METHODS: It is a retrospective study of all pediatric renal transplants performed at a single designated pediatric center between February 2010 and February 2024, including children aged 1-16 years.
RESULTS: Sixty-nine (44% female) pediatric renal transplants were performed, 36 from living-related donors and 33 from deceased donors. The mean age at transplant and last follow-up were 9.8 ± 3.6 years and 13.8 ± 4.7 years, respectively. ESRD etiologies included congenital anomalies of the kidney and urinary tract (39%), nephronophthisis (19%), glomerulonephritis (13%), and other causes (29%). Thirteen (19%) children underwent a preemptive transplant, whereas 56 (81%) were on dialysis at transplant. Thirty-one (45%) children had graft rejection: 16 (23%) in the first year, 9 (13%) in years 2-5, and 6 (9%) thereafter. Donor-specific antibodies (DSAs) were detected in 19 (28%) children; 17 (25%) of those had graft rejection with anti-DR or anti-DQ alloantibodies. Fourteen children had DSA-negative graft rejection. Of those, eight had cell-mediated rejection, and six had mixed rejection. Predictors of rejection were positive DSA (p = < 0.0001) and two DR mismatches (p = 0.029); three graft losses occurred. The prevalence of EBV, CMV, and BKV infection in the first year was 43%, 39%, and 33%, respectively, falling to 38%, 18%, and 12% in the subsequent years. Thirty-four (49%) children had at least one episode of culture-positive urinary tract infection. The 1-year and 5-year patient survival rates were 100% and 96.6%, and the corresponding graft survival rates were 98.1% and 89.7%, respectively.
CONCLUSION: The outcome of pediatric kidney transplants in Abu Dhabi over 14 years shows patient and graft survival comparable to published data. Acute graft rejection remains a major challenge with the presence of DSA and biallelic HLA-DR mismatch as independent predictors for rejection. Optimizing donor selection, immunosuppression, and closer surveillance are vital.