Evidence map›Paper›PMID 39938931›Full record

ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2025

Access to kidney transplantation and re-transplantation from childhood to adulthood: long-term data from the ERA Registry.

Evgenia Preka, Marjolein Bonthuis, Stephen D Marks, Anneke Kramer, Aiko P J de Vries, Søren S Sørensen, Sevcan A Bakkaloğlu, Claus Bistrup, Timo Jahnukainen, Olga L Rodriguez Arévalo and 15 more

Abstract read
In one paragraph

Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors.

Evgenia PrekaDepartment of Paediatric Nephrology, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris (APHP), INSERM U1163, Université de Paris Cité, Paris, France.ORCID 0000-0001-7130-0439
Marjolein BonthuisESPN/ERA Registry, Amsterdam UMC, location University of Amsterdam, Department of Medical Informatics, Amsterdam, the Netherlands.ORCID 0000-0003-1719-940X
Stephen D MarksDepartment of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Anneke KramerERA Registry, Amsterdam UMC location University of Amsterdam, Medical Informatics, Amsterdam, Netherlands.ORCID 0000-0002-7560-2669
Aiko P J de VriesDepartment of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands, Leiden Transplant Center, Leiden University Medical Center, Leiden, The Netherlands.ORCID 0000-0002-9284-3595
Søren S SørensenDepartment of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Sevcan A BakkaloğluGazi University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Nephrology, Ankara, Turkey.ORCID 0000-0001-6530-9672
Claus BistrupDepartment of Nephrology, Odense University Hospital, Odense, Denmark.
Timo JahnukainenDepartment of Pediatric Nephrology and Transplantation, New Children's Hospital, Helsinki University Hospital, Helsinki, Finland.ORCID 0000-0002-1815-7327
Olga L Rodriguez ArévaloRegistry of Kidney Patients of the Valencian Community, General Directorate of Public Health, Ministry of Health, Valencia, Spain.
Lukas BuchwinklerAustrian Dialysis and Transplant Registry, Department of Internal Medicine IV (Nephrology and Hypertension), Medical University Innsbruck, Innsbruck, Austria.ORCID 0009-0009-3057-7306
Mårten SegelmarkDepartment of Clinical Sciences in Lund, Lund University and Skane University Hospital, Lund, Sweden.ORCID 0000-0002-1221-0772
J Emilio SanchezDepartment of Nephrology, University Hospital of Cabuenes, Gijón, Asturias, Spain.ORCID 0000-0002-4431-3223
Miha ArnolDepartment of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Flor A Ordóñez-ÁlvarezPediatric Nephrology Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain.
Francisco de la Cerda-OjedaVirgen del Rocio Hospital, Seville, Spain.
Lucy A PlumbUniversity of Bristol Medical School, Bristol, UK.
Shona MethvenDepartment of Renal Medicine, Aberdeen Royal Infirmary, Scotland, UK.
Runolfur PalssonDivision of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
Torbjörn LundgrenDivision of Transplantation Surgery, CLINTEC, Karolinska Institute, Stockholm, Sweden.
Héctor RíosPediatric Nephrology Department, Hospital Universitari Vall d´Hebron, Barcelona, Spain.
Alberto OrtizDepartment of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain.ORCID 0000-0002-9805-9523
Vianda S StelERA Registry, Amsterdam UMC location University of Amsterdam, Medical Informatics, Amsterdam, Netherlands.ORCID 0000-0002-0007-1947
Jerome HarambatPediatric Nephrology Unit, Bordeaux University Hospital, Bordeaux, France.
Kitty J JagerDepartment of Paediatric Nephrology, Hôpital Universitaire Necker-Enfants Malades, Assistance Publique - Hôpitaux de Paris (APHP), INSERM U1163, Université de Paris Cité, Paris, France.ORCID 0000-0003-0444-8569

Funding

European Renal AssociationEuropean Society for Paediatric Nephrology
6 · The paper itself

Abstract

background and hypothesisKnowledge regarding access to first kidney transplantation (KT) and subsequent KT in patients commencing kidney replacement therapy (KRT) in childhood is limited.

methodsUsing European Renal Association (ERA) Registry data, we investigated European patients who started KRT below 20 years of age between 1978 and 2019. Access and determinants to first, second, and third KT were assessed using multivariable Cox regression.

resultsTotals of 12 623, 4077, and 1186 patients were included while awaiting first, second, and third KT, at median ages of 13.8 (IQR: 7.5-17.4), 20.9 (IQR: 16.5-26.1), and 26.6 (IQR: 20.3-32.8) years, respectively. During the study period, overall access was 87.8%, 72.7%, and 60.5% for first, second, and third KT, respectively, and median time to each KT was 0.9 (IQR: 0.2-2.1), 1.9 (0.6-4.5), and 2.6 (IQR: 1.0-5.3) years. Younger age at KRT initiation (aHR 0-4 vs. 10-14 years: 0.54; 95%CI: 0.51-0.57) and female sex (HR: 0.94; 95%CI: 0.90-0.98) were associated with lower access to first KT. KT candidates between 15 and 19 years had lower access to first and second KT (aHR: 0.69; 95%CI: 0.66-0.73, and aHR: 0.70; 95%CI: 0.61-0.81) compared to 10-14 year-olds. Compared to CAKUT, glomerulonephritis patients had lower access to KT (aHR: 0.75; 95%CI: 0.71-0.80 for first, aHR: 0.89; 95%CI: 0.81-0.98 for second, and aHR: 0.80; 95%CI: 0.66-0.97 for third KT). Similarly, patients with primary renal diseases with high risk of recurrence, had lower chances of receiving a first and second KT (aHR: 0.80; 95%CI: 0.76-0.85 for first, aHR: 0.86; 95%CI: 0.78-0.95 for second KT). Access to re-transplantation was also higher with previous pre-emptive KT and previous graft survival exceeding 5 years.

conclusionOur study highlights KT access disparities particularly for females, the youngest recipients, high-risk age (15-19 years), and diseases with recurrence risk. Notably, pre-emptive transplants and enduring previous grafts offer advantages regarding re-transplantation.

Indexed as

Health Services AccessibilityKidney Failure, ChronicKidney TransplantationRegistriesRenal Replacement TherapyReoperationAdolescentAdultChildChild, PreschoolFemaleFollow-Up StudiesGraft RejectionGraft SurvivalHumansMaleepidemiologyhigh-risk age windowkidney transplantationpaediatricre-transplantation

Identifiers

PMID39938931
PMCPMC12315802

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LicenceCC BY-NC
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.