Abstract
Background
Registry data can be used to assess associations between medical and health-policy factors and the likelihood of children on renal replacement therapy (RRT) to live with a functioning kidney transplant in Europe.
Methods
A survey questionnaire was distributed among renal registry representatives in 38 European countries, and additional data was obtained from the European Society for Pediatric Nephrology/European Renal Association–European Dialysis and Transplant Association (ESPN/ERA-EDTA) registry.
Results
Thirty-two countries with a pediatric RRT program responded. The median percentage of children by country on RRT with a functioning transplant was 62 % (interquartile range 39–77). One per million population increase in donation rate from deceased donors was associated with a 5 % increase in the percentage of functioning transplants; the existence of an intermediate and high pediatric priority policy doubled and tripled this percentage, respectively, compared with no priority, whereas an increase in living donor pediatric kidney transplant rate of one per million children was associated with a 14 % higher percentage of functioning transplants. The percentage of functioning transplants was also strongly associated with the gross domestic product (GDP).
Conclusion
Considerable variations exist in the percentages of prevalent pediatric RRT populations with functioning renal transplants across Europe. A macroeconomic indicator such as GDP is the most important determinant of these international differences. Efforts should be made for living donation programs and pediatric allocation priority to increase access to kidney transplantation for children.
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Abbreviations
- ANZDATA:
-
Australia and New Zealand Dialysis and Transplant Registry
- CI:
-
Confidence interval
- DD:
-
Deceased donor
- ESPN/ERA-EDTA:
-
European Society for Pediatric Nephrology/European Renal Association–European Dialysis and Transplant Association
- ESRD:
-
End-stage renal disease
- GDP:
-
Gross domestic product per capita
- KTx:
-
Kidney transplantation
- LD:
-
Living donor
- pmcp:
-
Per million child population
- pmp:
-
Per million population
- RR:
-
Relative risk
- RRT:
-
Renal replacement therapy
- USRDS:
-
United States Renal Data System
- WHO:
-
World Health Organization
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Acknowledgments
JH was supported by an ERA-EDTA QUEST initiative research fund and received travel assistance from Astellas Pharma, Fresenius Medical Care, Pfizer, and Sandoz.
We are very grateful to the following persons and registries for their participation in the data collection of this study:
Austria: R. Kramar (Austrian Dialysis and Transplant Registry); Belarus: S. Baiko (Department of Pediatrics, Minsk University Hospital); Belgium: K. van Hoeck and A. Raes (Belgian Pediatric Nephrology Registry); Bulgaria: D. Roussinov (Department of Pediatrics, Sofia University Hospital); Croatia: Z. Puretic (Department of Pediatrics, Zagreb University Hospital); Czech Republic: T Seeman (Department of Pediatrics, Prague University Hospital); Denmark: J. Heaf (Danish Renal Registry), SS. Sorensen (Department of Nephrology, Copenhagen University Hospital); Estonia: U. Toots (Department of Pediatrics, Tallin University Hospital); Eurotransplant International: V. Diepeveen-Huijsman, I. Tieken, A. Rahmel and J. de Boer; Finland: P. Finne (Finnish Registry for Kidney Diseases); France: MA. Macher (Biomedicine Agency); FYROM: N. Ristoska-Bojkovska (Department of Pediatrics, Skopje University Hospital); Germany: B. Tönshoff (CERTAIN Registry); Greece: G.A. Ioannidis (Hellenic Renal Registry); Hungary: G. Reusz (Department of Pediatrics, Semmelweis University Hospital Budapest); Iceland: V. Edvardsson (Department of Pediatrics, Reykjavik University Hospital); Italy: E. Verrina, L. Dello Strologo, S. Testa (Italian Registry of Pediatric Chronic Dialysis); Lithuania: A. Jankauskiene (Department of Pediatrics, Vilnius University Hospital); Norway: T. Leivestad (Norwegian Renal Registry); Poland: R. Grenda and J. Rubik (Department of Pediatric Nephrology, Children’s Memorial Health Institute); Portugal: C. Mota (Department of Pediatric Nephrology, Porto University Hospital); Romania: L. Garneata (Romanian Renal Registry); Russia: EA. Molchanova (Russian Pediatric RRT Registry); Serbia: M. Kostic (Department of Pediatric Nephrology, Belgrade University Hospital); Slovakia: G. Kolvek (Department of Pediatrics, Kosice University Hospital); Slovenia: G. Novljan (Department of Pediatrics, Ljubljana University Hospital); Sweden: KG. Prütz (Swedish Transplant registry), S. Hansson (Department of Pediatrics, Göteborg University Hospital); Switzerland: GF. Laube (Department of Pediatrics, Zurich University Hospital); Spain: A. Alonso Melgar (Spanish Pediatric Renal Registry); the Netherlands: AC. Hemke (Dutch End Stage Renal Disease Registry); Turkey: R. Topaloglu (Department of Pediatrics, Hacettepe University Hospital Ankara); Ukraine: D. Ivanov (Department of Pediatrics, Kiev University Hospital); United Kingdom: H. Maxwell (UK Renal Registry).
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Harambat, J., van Stralen, K.J., Verrina, E. et al. Likelihood of children with end-stage kidney disease in Europe to live with a functioning kidney transplant is mainly explained by nonmedical factors. Pediatr Nephrol 29, 453–459 (2014). https://doi.org/10.1007/s00467-013-2665-7
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DOI: https://doi.org/10.1007/s00467-013-2665-7