Policy variation in donor and recipient status in 11 pediatric renal transplantation centers
- Maike van HuisAffiliated withDepartments of Pediatric Nephrology, Emma Children’s Hospital Academic Medical Center
- , Nikki J. SchoenmakerAffiliated withDepartments of Pediatric Nephrology, Emma Children’s Hospital Academic Medical CenterDialysis Department, Academic Medical Center Email author
- , Jaap W. GroothoffAffiliated withDepartments of Pediatric Nephrology, Emma Children’s Hospital Academic Medical Center
- , Johanna H. van der LeeAffiliated withClinical Research Unit, Division Woman-Child, Academic Medical Center
- , Karlien CransbergAffiliated withSophia Children’s Hospital, Erasmus MC
- , on behalf of the RICH-Q Group
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Evidence-based guidelines for pediatric renal transplantation (Tx) are lacking. This may lead to unwanted treatment variations. We aimed to quantify the variation in treatment policies and its consequences in daily practice in 11 centers that provide renal Tx for children in three European countries.
We surveyed Tx policies in all ten centers in the Netherlands and Belgium and one center in Germany. We compared Tx policies with the therapies actually provided and with recommendations from available published guidelines and existing literature. Information on treatment policies was obtained by a questionnaire; information on care actually provided was registered prospectively from 2007 to 2011. The clinical guidelines were identified by searches of MEDLINE and websites of pediatric nephrology organizations.
Between centers, we found discrepancies in policies on: the minimum accepted recipient weight (8–12 kg), the maximum living and deceased donor age (50–75 and 45–60 years, respectively). HLA-match policies varied between acceptation of all mismatches to at least 1A1B1DR match donor transplantations amounting to 49 % in the Netherlands versus 26 % in Belgium (p = 0.006).
Management policies for renal Tx in children vary considerably between centers and nations. This has a direct impact on the delivered care, and by extrapolation, on health outcome.
KeywordsPediatric Renal transplantation Policies Guidelines
- Policy variation in donor and recipient status in 11 pediatric renal transplantation centers
Volume 28, Issue 6 , pp 951-957
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- 1. Departments of Pediatric Nephrology, Emma Children’s Hospital Academic Medical Center, Amsterdam, The Netherlands
- 4. Dialysis Department, Academic Medical Center, A01.247, Postbox 22660, 1100 DD, Amsterdam, The Netherlands
- 2. Clinical Research Unit, Division Woman-Child, Academic Medical Center, Amsterdam, The Netherlands
- 3. Sophia Children’s Hospital, Erasmus MC, Rotterdam, The Netherlands