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Pediatric kidney transplantation in China: an analysis from the IPNA Global Kidney Replacement Therapy Registry

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Abstract

Background

The International Pediatric Nephrology Association (IPNA) Global Kidney Replacement Therapy (KRT) Registry was established to evaluate the incidence and outcomes of kidney replacement therapy (dialysis and transplantation) provided to children worldwide. Analysis of registry data for separate regions is feasible.

Methods

Three centers located in Shanghai, Guangzhou, and Zhengzhou, which have the greatest number of pediatric kidney transplantation cases in China, participated in this analysis of transplant data. Data were registered by each center for patients under the age of 19 years who received a single-organ kidney transplant for the first time between 2011 and 2018.

Results

In total, 415 patients (59.8% male) aged 1.4–18.7 (median 12.1) years were followed for 0.3–97.1 (median 27.7) months. The number of kidney transplants increased from a total of 129 during 2011–2014 to 286 cases during 2015–2018. 85.8% of patients received the transplanted kidney from a pediatric (age < 19 years) donor, and deceased donors accounted for 94% of all donors. 8.0% of grafts were lost. One and 5-year patient survival rates were 97.6% and 95.5%, respectively. The major cause of death was infection (7/14). Similar graft and patient survival rates were observed for organs from pediatric and adult donors in 6–11 and 12–18 year recipient age groups, whereas recipients < 6 years showed inferior patient and graft survival.

Conclusions

Pediatric kidney transplantation shows favorable short-term and medium-term outcomes in China. Our experience supports use of pediatric donors in pediatric kidney transplantation, but attention directed to the outcome of recipients aged under 6 is necessary.

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Data availability

All data generated or analyzed during this study are included in this paper.

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Funding

This study was funded by multicenter clinical research project of Shanghai Municipal Health Commission (Pediatrics) (EKYY20180201).

Author information

Author notes

  1. Qian Shen and Xiaoyan Fang contributed equally to this work.

Authors and Affiliations

  1. Department of Nephrology, Children’s Hospital of Fudan University, Shanghai, China

    Qian Shen, Xiaoyan Fang, Xinyue Man, Yihui Zhai, Jing Chen, Jia Rao & Hong Xu

  2. Organ Transplant Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Longshan Liu & Changxi Wang

  3. Department of Kidney Transplantation, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    Wenjun Shang & Guiwen Feng

  4. Department of Organ Transplantation, Changhai Hospital, Second Military Medical University, Shanghai, China

    Lei Zhang, Li Zeng & Youhua Zhu

  5. Division of Pediatric Nephrology, Children’s Mercy Kansas City, Kansas City, MO, USA

    Bradley A Warady

  6. Pediatric Nephrology Division, Heidelberg University Center for Pediatrics and Adolescent Medicine, Heidelberg, Germany

    Franz Schaefer

Authors
  1. Qian Shen
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  2. Xiaoyan Fang
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  16. Hong Xu
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Contributions

Each author has participated sufficiently in the work to take public responsibility for the content. Hong Xu and Qian Shen participated in the conception and design of the study; Qian Shen, Xiaoyan Fang, Xinyue Man, Yihui Zhai, Longshan Liu, Changxi Wang, Wenjun Shang, Guiwen Feng, Lei Zhang, and Li Zeng conducted data acquisition, analysis, and interpretation; Qian Shen and Xiaoyan Fang drafted the article and provided intellectual content of critical importance to the work described; Hong Xu, Bradley A Warady, Franz Schaefer, Youhua Zhu, Jing Chen, and Jia Rao revised the article. All authors have final approval of the version to be published.

Corresponding author

Correspondence to Hong Xu.

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The authors declare that they have no conflict of interest.

Ethics approval

This study was approved by the Ethics Board of the Children’s Hospital of Fudan University.

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Shen, Q., Fang, X., Man, X. et al. Pediatric kidney transplantation in China: an analysis from the IPNA Global Kidney Replacement Therapy Registry. Pediatr Nephrol 36, 685–692 (2021). https://doi.org/10.1007/s00467-020-04745-7

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  • DOI: https://doi.org/10.1007/s00467-020-04745-7

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