Outcome of renal transplantation in small infants

a match-controlled analysis

Marcus Weitz, Guido F Laube, Maria Schmidt, Kai Krupka, Luisa Murer, Dominik Müller, Bernd Hoppe, Anja Büscher, Jens König, Martin Pohl, Therese Jungraithmayr, Florian Thiel, Heiko Billing, Ryszard Grenda, Jacek Rubik, Michael M Kaabak, Fatos Yalcinkaya, Rezan Topaloglu, Nicholas Webb, Luca Dello Strologo & 3 others Lars Pape, Silvio Nadalin, Burkhard Tönshoff

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Infants with a body weight of less than 10 kg are often not considered to be suitable candidates for renal transplantation (RTx). The objective of this study was to evaluate this arbitrary weight threshold for pediatric RTx.

METHODS: We conducted a multicenter, retrospective, match-controlled cohort study on infants weighing less than 10 kg at time of engrafting (low-weight group [LWG], n = 38) compared to a matched control group (n = 76) with a body weight of 10-15 kg, using data from the first 2 years post-transplant derived from the CERTAIN Registry.

RESULTS: Patient survival was 97 and 100% in the LWG and control groups, respectively (P = 0.33), and death-censored graft survival was 100 and 95% in the LWG and control groups, respectively (P = 0.30). Estimated glomerular filtration rate at 2 years post-transplant was excellent and comparable between the groups (LWG 77.6 ± 34.9 mL/min/1.73 m2; control 74.8 ± 29.1 mL/min/1.73 m2; P = 0.68). The overall incidences of surgery-related complications (LWG 11%, control 23%; P = 0.12) and medical outcome measures (LWG 23%, control 36%, P = 0.17) were not significantly different between the groups. The medical outcome measures included transplant-related viral diseases (LWG 10%, control 21%; P = 0.20), acute rejection episodes (LWG 14%, control 29%; P = 0.092), malignancies (LWG 3%, control 0%; P = 0.33) and arterial hypertension (LWG 73%, control 67%; P = 0.57).

CONCLUSIONS: These data suggest that RTx in low-weight children is a feasible option, at least in selected centers with appropriate surgical and medical expertise.

Original languageEnglish
Pages (from-to)1057-1068
Number of pages12
JournalPediatric Nephrology
Volume33
Issue number6
DOIs
Publication statusPublished - Jun 2018

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Kidney Transplantation
Weights and Measures
Control Groups
Transplants
Body Weight
Outcome Assessment (Health Care)
Graft Survival
Virus Diseases
Glomerular Filtration Rate
Registries
Cohort Studies
Research Design
Pediatrics
Hypertension
Survival

Cite this

Weitz, M., Laube, G. F., Schmidt, M., Krupka, K., Murer, L., Müller, D., ... Tönshoff, B. (2018). Outcome of renal transplantation in small infants: a match-controlled analysis. Pediatric Nephrology, 33(6), 1057-1068. https://doi.org/10.1007/s00467-018-3895-5

Outcome of renal transplantation in small infants : a match-controlled analysis. / Weitz, Marcus; Laube, Guido F; Schmidt, Maria; Krupka, Kai; Murer, Luisa; Müller, Dominik; Hoppe, Bernd; Büscher, Anja; König, Jens; Pohl, Martin; Jungraithmayr, Therese; Thiel, Florian; Billing, Heiko; Grenda, Ryszard; Rubik, Jacek; Kaabak, Michael M; Yalcinkaya, Fatos; Topaloglu, Rezan; Webb, Nicholas; Dello Strologo, Luca; Pape, Lars; Nadalin, Silvio; Tönshoff, Burkhard.

In: Pediatric Nephrology, Vol. 33, No. 6, 06.2018, p. 1057-1068.

Research output: Contribution to journalArticle

Weitz, M, Laube, GF, Schmidt, M, Krupka, K, Murer, L, Müller, D, Hoppe, B, Büscher, A, König, J, Pohl, M, Jungraithmayr, T, Thiel, F, Billing, H, Grenda, R, Rubik, J, Kaabak, MM, Yalcinkaya, F, Topaloglu, R, Webb, N, Dello Strologo, L, Pape, L, Nadalin, S & Tönshoff, B 2018, 'Outcome of renal transplantation in small infants: a match-controlled analysis', Pediatric Nephrology, vol. 33, no. 6, pp. 1057-1068. https://doi.org/10.1007/s00467-018-3895-5
Weitz M, Laube GF, Schmidt M, Krupka K, Murer L, Müller D et al. Outcome of renal transplantation in small infants: a match-controlled analysis. Pediatric Nephrology. 2018 Jun;33(6):1057-1068. https://doi.org/10.1007/s00467-018-3895-5
Weitz, Marcus ; Laube, Guido F ; Schmidt, Maria ; Krupka, Kai ; Murer, Luisa ; Müller, Dominik ; Hoppe, Bernd ; Büscher, Anja ; König, Jens ; Pohl, Martin ; Jungraithmayr, Therese ; Thiel, Florian ; Billing, Heiko ; Grenda, Ryszard ; Rubik, Jacek ; Kaabak, Michael M ; Yalcinkaya, Fatos ; Topaloglu, Rezan ; Webb, Nicholas ; Dello Strologo, Luca ; Pape, Lars ; Nadalin, Silvio ; Tönshoff, Burkhard. / Outcome of renal transplantation in small infants : a match-controlled analysis. In: Pediatric Nephrology. 2018 ; Vol. 33, No. 6. pp. 1057-1068.
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abstract = "BACKGROUND: Infants with a body weight of less than 10 kg are often not considered to be suitable candidates for renal transplantation (RTx). The objective of this study was to evaluate this arbitrary weight threshold for pediatric RTx.METHODS: We conducted a multicenter, retrospective, match-controlled cohort study on infants weighing less than 10 kg at time of engrafting (low-weight group [LWG], n = 38) compared to a matched control group (n = 76) with a body weight of 10-15 kg, using data from the first 2 years post-transplant derived from the CERTAIN Registry.RESULTS: Patient survival was 97 and 100{\%} in the LWG and control groups, respectively (P = 0.33), and death-censored graft survival was 100 and 95{\%} in the LWG and control groups, respectively (P = 0.30). Estimated glomerular filtration rate at 2 years post-transplant was excellent and comparable between the groups (LWG 77.6 ± 34.9 mL/min/1.73 m2; control 74.8 ± 29.1 mL/min/1.73 m2; P = 0.68). The overall incidences of surgery-related complications (LWG 11{\%}, control 23{\%}; P = 0.12) and medical outcome measures (LWG 23{\%}, control 36{\%}, P = 0.17) were not significantly different between the groups. The medical outcome measures included transplant-related viral diseases (LWG 10{\%}, control 21{\%}; P = 0.20), acute rejection episodes (LWG 14{\%}, control 29{\%}; P = 0.092), malignancies (LWG 3{\%}, control 0{\%}; P = 0.33) and arterial hypertension (LWG 73{\%}, control 67{\%}; P = 0.57).CONCLUSIONS: These data suggest that RTx in low-weight children is a feasible option, at least in selected centers with appropriate surgical and medical expertise.",
author = "Marcus Weitz and Laube, {Guido F} and Maria Schmidt and Kai Krupka and Luisa Murer and Dominik M{\"u}ller and Bernd Hoppe and Anja B{\"u}scher and Jens K{\"o}nig and Martin Pohl and Therese Jungraithmayr and Florian Thiel and Heiko Billing and Ryszard Grenda and Jacek Rubik and Kaabak, {Michael M} and Fatos Yalcinkaya and Rezan Topaloglu and Nicholas Webb and {Dello Strologo}, Luca and Lars Pape and Silvio Nadalin and Burkhard T{\"o}nshoff",
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TY - JOUR

T1 - Outcome of renal transplantation in small infants

T2 - a match-controlled analysis

AU - Weitz, Marcus

AU - Laube, Guido F

AU - Schmidt, Maria

AU - Krupka, Kai

AU - Murer, Luisa

AU - Müller, Dominik

AU - Hoppe, Bernd

AU - Büscher, Anja

AU - König, Jens

AU - Pohl, Martin

AU - Jungraithmayr, Therese

AU - Thiel, Florian

AU - Billing, Heiko

AU - Grenda, Ryszard

AU - Rubik, Jacek

AU - Kaabak, Michael M

AU - Yalcinkaya, Fatos

AU - Topaloglu, Rezan

AU - Webb, Nicholas

AU - Dello Strologo, Luca

AU - Pape, Lars

AU - Nadalin, Silvio

AU - Tönshoff, Burkhard

PY - 2018/6

Y1 - 2018/6

N2 - BACKGROUND: Infants with a body weight of less than 10 kg are often not considered to be suitable candidates for renal transplantation (RTx). The objective of this study was to evaluate this arbitrary weight threshold for pediatric RTx.METHODS: We conducted a multicenter, retrospective, match-controlled cohort study on infants weighing less than 10 kg at time of engrafting (low-weight group [LWG], n = 38) compared to a matched control group (n = 76) with a body weight of 10-15 kg, using data from the first 2 years post-transplant derived from the CERTAIN Registry.RESULTS: Patient survival was 97 and 100% in the LWG and control groups, respectively (P = 0.33), and death-censored graft survival was 100 and 95% in the LWG and control groups, respectively (P = 0.30). Estimated glomerular filtration rate at 2 years post-transplant was excellent and comparable between the groups (LWG 77.6 ± 34.9 mL/min/1.73 m2; control 74.8 ± 29.1 mL/min/1.73 m2; P = 0.68). The overall incidences of surgery-related complications (LWG 11%, control 23%; P = 0.12) and medical outcome measures (LWG 23%, control 36%, P = 0.17) were not significantly different between the groups. The medical outcome measures included transplant-related viral diseases (LWG 10%, control 21%; P = 0.20), acute rejection episodes (LWG 14%, control 29%; P = 0.092), malignancies (LWG 3%, control 0%; P = 0.33) and arterial hypertension (LWG 73%, control 67%; P = 0.57).CONCLUSIONS: These data suggest that RTx in low-weight children is a feasible option, at least in selected centers with appropriate surgical and medical expertise.

AB - BACKGROUND: Infants with a body weight of less than 10 kg are often not considered to be suitable candidates for renal transplantation (RTx). The objective of this study was to evaluate this arbitrary weight threshold for pediatric RTx.METHODS: We conducted a multicenter, retrospective, match-controlled cohort study on infants weighing less than 10 kg at time of engrafting (low-weight group [LWG], n = 38) compared to a matched control group (n = 76) with a body weight of 10-15 kg, using data from the first 2 years post-transplant derived from the CERTAIN Registry.RESULTS: Patient survival was 97 and 100% in the LWG and control groups, respectively (P = 0.33), and death-censored graft survival was 100 and 95% in the LWG and control groups, respectively (P = 0.30). Estimated glomerular filtration rate at 2 years post-transplant was excellent and comparable between the groups (LWG 77.6 ± 34.9 mL/min/1.73 m2; control 74.8 ± 29.1 mL/min/1.73 m2; P = 0.68). The overall incidences of surgery-related complications (LWG 11%, control 23%; P = 0.12) and medical outcome measures (LWG 23%, control 36%, P = 0.17) were not significantly different between the groups. The medical outcome measures included transplant-related viral diseases (LWG 10%, control 21%; P = 0.20), acute rejection episodes (LWG 14%, control 29%; P = 0.092), malignancies (LWG 3%, control 0%; P = 0.33) and arterial hypertension (LWG 73%, control 67%; P = 0.57).CONCLUSIONS: These data suggest that RTx in low-weight children is a feasible option, at least in selected centers with appropriate surgical and medical expertise.

U2 - 10.1007/s00467-018-3895-5

DO - 10.1007/s00467-018-3895-5

M3 - Article

VL - 33

SP - 1057

EP - 1068

JO - Pediatric Nephrology

JF - Pediatric Nephrology

SN - 0931-041X

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