Study of psychosocial parameters related to the survival rate of renal transplantation in children

Abstract.

The purpose of the present study was to assess the effect of intelligence, schooling, psychomotor, emotional, and social status on renal graft survival in children. Sixty-two cadaver renal transplant recipients were evaluated retrospectively and the influence of sex, age, weight, and the use of cyclosporin A (CyA) on the success rate of the graft from 1 to 5 years later was analyzed. Psychological and social scores were devised and included as factors predictive of survival of the graft. Univariate analysis showed that the following variables predicted renal graft survival: the use of CyA (P = 0.0002), pre-transplant dialysis (P = 0.04), weight at the time of transplantation (P = 0.072), and psychological scores (P = 0.064). Association analysis demonstrated that pre-transplantation dialysis was only a chance association and therefore the parameter was discarded. Multivariate analysis showed that the predictive parameters were the use of CyA, sex, weight in kilograms, and the psychological score. An equation was then derived from variables that predict the probability that a specific patient’s graft will survive more than t months. This equation is the estimated survival distribution function and is as follow: S (t) = Exp {–Exp[–(0.8882x ₁–1.827x ₂+0.037x ₃–0.1746x ₄)+ln t–4.7862]} where S (t) = the survival at t months post transplantation, x ₁ = sex (male 1, female 2), x ₂ = CyA (yes 1, no 2), x ₃ = weight in kilograms, and x ₄ = psychological score. The major impact of psychological factors on renal graft survival was surprising.