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Changes in graft function after living donor kidney transplantation in children

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Abstract

Background

This study aimed to evaluate the change in graft function in two groups stratified by the estimated glomerular filtration rate (eGFR) at 1 month after transplantation (eGFR-1 M) in pediatric living donor kidney transplant recipients.

Methods

Forty-three pediatric recipients were classified as those with an eGFR-1 M ≥ 90 mL/min/1.73 m2 (n = 19; high eGFR group) or those with an eGFR-1 M of 60–89 mL/min/1.73 m2 (n = 24; middle eGFR group). In the two groups, changes in the eGFR were retrospectively evaluated for 5 years after kidney transplantation.

Results

The mean recipient age at transplantation in the high/middle eGFR group was 6.1 ± 3.4/7.8 ± 4.0 years (P = 0.14). The mean eGFR-1, -12, and -60 M (mL/min/1.73 m2) in the high/middle eGFR group were 106.8 ± 2.99/78.5 ± 1.52 (P < 0.001), 79.3 ± 3.22/62.7 ± 2.38 (P < 0.001), and 73.1 ± 4.16/59.2 ± 2.79 (P = 0.006), respectively. The change in the mean eGFR remained mostly parallel in the two groups. In both groups, the eGFR significantly decreased only between 1 and 12 months after transplantation (P < 0.0001). Approximately 70% of the patients had an eGFR-60 M ≥ 60 mL/min/1.73 m2.

Conclusions

The high and middle eGFR groups showed a rapid decline in the eGFR by 1 year after transplantation, but the change thereafter was gradual. In pediatric living donor kidney transplant recipients, the eGFR was relatively well maintained up to 5 years after transplantation.

Graphical abstract

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available owing to privacy or other restrictions, but are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Acknowledgements

We thank Ellen Knapp, PhD, from Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan

    Junya Hashimoto, Yuko Hamasaki, Yujiro Aoki, Mai Kubota, Masaki Muramatsu, Takeshi Kawamura & Ken Sakai

  2. Department of Pediatric Nephrology, Faculty of Medicine, Toho University, Tokyo, Japan

    Seiichiro Shishido

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  1. Junya Hashimoto
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  2. Yuko Hamasaki
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  3. Yujiro Aoki
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  4. Mai Kubota
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  7. Seiichiro Shishido
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  8. Ken Sakai
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Contributions

Junya Hashimoto and Yuko Hamasaki contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Junya Hashimoto, Yuko Hamasaki, Yujiro Aoki, Mai Kubota, Masaki Muramatsu, Takeshi Kawamura, Seiichiro Shishido, and Ken Sakai. The first draft of the manuscript was written by Junya Hashimoto, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yuko Hamasaki.

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Ethics approval

The study was approved by the ethics committee of Toho University Omori Medical Center (ID: M20114 17170).

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Informed consent was obtained from all individual participants or their parents.

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Not applicable.

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The authors declare no competing interests.

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Hashimoto, J., Hamasaki, Y., Aoki, Y. et al. Changes in graft function after living donor kidney transplantation in children. Pediatr Nephrol 38, 291–297 (2023). https://doi.org/10.1007/s00467-022-05540-2

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  • DOI: https://doi.org/10.1007/s00467-022-05540-2

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