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Original Report: Transplantation

Trajectories and Predictors of Allograft Dysfunction after Renal Transplantation in Children

de Souza V.C.c-e,k · Rabilloud M.f-h,l · Cochat P.h-j · Wagner M.B.a, c · Garcia C.D.b · Ranchin B.j · Iwaz J.f-h,l · Selistre L.a,d,e,k · Dubourg L.h,i,k

Author affiliations

aPontifícia Universidade Católica do Rio Grande do Sul, bUniversidade Federal de Ciências da Saúde de Porto Alegre, cUniversidade Federal do Rio Grande do Sul, Programa de Pós Graduação em Saúde da Criança e do Adolescente, Porto Alegre, dUniversidade de Caxias do Sul, Programa de Pós Graduação em Ciências da Saúde, Caxias do Sul, and eFellow CAPES Foundation, Ministry of Education of Brazil, Brasilia/DF, Brazil; fUniversité Lyon 1, gCNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, hUniversité de Lyon, iUMR 5305 CNRS/Université Claude Bernard, Biologie Tissulaire et Ingénierie Thérapeutique, and jCentre de Référence des Maladies Rénales Rares, Service de Néphrologie Rhumatologie Dermatologie Pédiatriques, kExploration Fonctionnelle Rénale et Métabolique, Groupement Hospitalier Edouard Herriot, and lService de Biostatistique, Hospices Civils de Lyon, Lyon, France

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Am J Nephrol 2017;45:63-68

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Article / Publication Details

First-Page Preview
Abstract of Original Report: Transplantation

Received: July 19, 2016
Accepted: November 02, 2016
Published online: November 29, 2016
Issue release date: January 2017

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: https://www.karger.com/AJN

Abstract

Background: The survival rates of renal transplant children are indeed on the rise, but it is still important to ensure that there is optimal renal function in these children in all their future growing years. The number of functioning nephrons and the graft ability to adapt to an increasing demand during body growth seem to be the most important factors for long-term allograft function. This study examined the long-term change in the glomerular filtration rate in a pediatric kidney transplant cohort and the importance of the recipient and donor ages in predicting transplant outcome. Methods: Data on 67 renal transplant children who underwent 278 inulin-clearance measurements between 2000 and 2010 were examined. A longitudinal latent class model was used to identify renal function trajectories and classify the children. Results: This model identified 3 trajectories of renal allograft function after pediatric kidney transplantation: ‘low and decreasing', ‘moderate and stable', and ‘high and sharply decreasing'. The probability of belonging to the low and decreasing trajectory - that is, the poorer outcome - was lower in recipients of grafts from living versus deceased donor (adjusted OR (aOR) 0.02; p = 0.03). This probability increased with recipient age (aOR 1.20 per year of recipient ageing; p = 0.07) and donor-recipient age-difference (aOR 1.13 per additional year; p = 0.07). Conclusion: This study suggests that donation from living donors and from younger donors are favorable factors for long-term allograft function.

© 2016 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Original Report: Transplantation

Received: July 19, 2016
Accepted: November 02, 2016
Published online: November 29, 2016
Issue release date: January 2017

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 2

ISSN: 0250-8095 (Print)
eISSN: 1421-9670 (Online)

For additional information: https://www.karger.com/AJN


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