Experience of the first 6 years of pediatric kidney transplantation in Indonesia: A multicenter retrospective study

• Published in: Pediatric transplantation 2020-12, Vol.24 (8), p.e13812-n/a
• Main Authors: Ambarsari, Cahyani Gita, Hidayati, Eka Laksmi, Trihono, Partini Pudjiastuti, Saraswati, Meilania, Rodjani, Arry, Wahyudi, Irfan, Situmorang, Gerhard Reinaldi, Kim, Jon Jin, Mellyana, Omega, Kadaristiana, Agustina
• Format: Article
• Language: English
• Subjects: Dialysis; Graft rejection; graft survival; Kidney transplantation; Kidney transplants; living donor; Pediatrics; Renal failure; retrospective study; Survival; Survival analysis; Transplants & implants; Urinary tract
• ISSN: 1397-3142; 1399-3046
• DOI: 10.1111/petr.13812

Background Pediatric kidney transplantation was only introduced in Indonesia in 2013. We therefore aimed to assess the characteristics and outcomes of transplants performed from its inception to January 2019. Method The study had a dual‐center retrospective design. We examined the records of kidney transplant recipients and then calculated patient and graft survival rates by Kaplan‐Meier survival analysis with 95% confidence intervals (95% CI). Results In total, 12 kidney transplantations were performed in eleven children during the study period; among these, ten were boys, and nine had renal failure caused by congenital anomaly of the kidney or urinary tract. All donors were living, and all recipients were on dialysis at the time of transplantation, when their median age was 14.5 years (range, 8‐19 years). Three patients died of infection in the first year of follow‐up and two lost their allograft by the time of their last follow‐up (median, 13 months; range, 4‐69 months). The 1‐year patient survival rate was therefore 68.18% (95% CI, 29.72%‐88.61%), which remained unchanged at 3 and 5 years. However, the non‐death‐censored graft survival rates at 1, 3, and 5 years were 68.18% (95% CI, 29.72%‐88.61%), 51.14% (95% CI, 14.5%‐79.46%), and 25.57% (95% CI, 1.38%‐64.78%), respectively. Conclusion Patient and graft survival rates after pediatric kidney transplantation in Indonesia are lower than those reported in other countries. Closer patient follow‐up and stricter adherence to guidelines could improve transplant outcomes, but we must seek to improve the balance between infection and rejection.