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More than four decades of graft survival in pediatric kidney transplant recipients

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Abstract

Background

Early in the history of kidney transplantation, short-term graft survival was low. Yet some have had excellent long-term survival. Herein, we describe characteristics of pediatric recipients with > 40 years of graft survival currently alive with a functioning first graft.

Methods

We reviewed all pediatric (age < 18 years) kidney transplants performed at the University of Minnesota between January 1, 1970, and December 31, 1979 (n = 148), to identify all recipients currently alive with a functioning first graft. Data are presented as medians with interquartile ranges (IQR) and proportions.

Results

We identified 10 recipients with > 40-year graft survival (median follow-up: 45.0 years (IQR: 43.1, 48.1)). The median age at transplant was 13.8 years (IQR: 5.1, 16.3). All recipients were white; half were male. Of the 10, 4 had glomerulonephritis, 2 had congenital anomalies of the kidney and the urinary tract, 2 had congenital nephrotic syndrome, 1 had Alport syndrome, and 1 had cystic kidney disease as kidney failure cause. Nine patients received a living-related donor transplant, and 1 patient received a deceased-donor transplant. The median estimated glomerular filtration rate at 20 years post-transplant was 79.9 (IQR: 72.3, 98.4); at 30 years, 67.7 (IQR: 63.2, 91.8); and at 40 years, 80.3 ml/min/1.73 m2 (IQR: 73.7, 86.0). None developed rejection, 5 developed hypertension, 2 developed dyslipidemia, 1 developed diabetes, and 7 patients developed malignancy (4 skin cancer, 2 breast cancer, and 1 post-transplant lymphoproliferative disease).

Conclusion

Pediatric kidney transplant recipients may achieve > 4 decades of graft survival. Cancer is a common complication warranting vigilant screening.

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Fig. 1

Data availability

Data are available from the corresponding author upon request.

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Department of Pediatrics, University of Minnesota, 2450 Riverside Ave, AOB 201, Minneapolis, MN, 55454, USA

    Sarah Kizilbash, Michelle Rheault, Michael Mauer, Thomas Nevins & Blanche Chavers

  2. Department of Surgery, University of Minnesota, Minneapolis, MN, USA

    Arthur Matas

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  1. Sarah Kizilbash
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  2. Michelle Rheault
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  3. Arthur Matas
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  4. Michael Mauer
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  5. Thomas Nevins
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  6. Blanche Chavers
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Correspondence to Sarah Kizilbash.

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Kizilbash, S., Rheault, M., Matas, A. et al. More than four decades of graft survival in pediatric kidney transplant recipients. Pediatr Nephrol 39, 631–635 (2024). https://doi.org/10.1007/s00467-023-06153-z

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  • DOI: https://doi.org/10.1007/s00467-023-06153-z

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