Acute rejection in pediatric renal transplantation: Retrospective study of epidemiology, risk factors, and impact on renal function

AR is a major relevant and challenging topic in pediatric kidney transplantation. Our objective was to evaluate cumulative incidence of AR in pediatric kidney transplant patient, risk factors for this outcome, and impact on allograft function and survival. A retrospective cohort including pediatric...

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Bibliographic Details
Published in:Pediatric transplantation 2021-03, Vol.25 (2), p.e13856-n/a
Main Authors: Nascimento Ghizoni Pereira, Luiza, Tedesco‐Silva, Hélio, Koch‐Nogueira, Paulo Cesar
Format: Article
Language:English
Subjects:
Adolescent
Brazil - epidemiology
Child
Child, Preschool
Cytomegalovirus
Epidemiology
Female
Follow-Up Studies
Graft rejection
Graft Rejection - epidemiology
Graft Rejection - etiology
Graft Rejection - physiopathology
Graft Survival
Humans
Incidence
Kaplan-Meier Estimate
Kidney - physiopathology
Kidney Function Tests
Kidney Transplantation
Kidney transplants
Male
Pediatrics
Proportional Hazards Models
Renal function
Retrospective Studies
Risk Factors
Survival
Transplants & implants
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Summary:AR is a major relevant and challenging topic in pediatric kidney transplantation. Our objective was to evaluate cumulative incidence of AR in pediatric kidney transplant patient, risk factors for this outcome, and impact on allograft function and survival. A retrospective cohort including pediatric patients that underwent kidney transplantation between 2011 and 2015 was designed. Risk factors for AR were tested by competing risk analysis. To estimate its impact, graft survival and difference in GFR were evaluated. Two hundred thirty patients were included. As a whole, the incidence of AR episodes was 0.16 (95% CI = 0.12‐0.20) per person‐year of follow‐up. And cumulative incidence of AR was 23% in 1 year and 39% in 5 years. Risk factors for AR were number of MM (SHR 1.36 CI 1.14‐1.63 P = .001); ISS with CSA, PRED, and AZA (SHR 2.22 CI 1.14‐4.33 P = .018); DGF (SHR 2.49 CI 1.57‐3.93 P 
ISSN:1397-3142
1399-3046
DOI:10.1111/petr.13856