Evidence map›Paper›PMID 40775406›Full record

ArticlePediatric nephrology (Berlin, Germany)2025

Incidence and determinants of graft failure and death with functioning graft after re-transplantation.

Ferran Coens, Dries Reynders, Els Goetghebeur, Ineke Tieken, Serge Vogelaar, Kai Krupka, Ann Raes, Frans Claas, Burkhard Tönshoff, Agnieszka Prytuła

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Article in Pediatric nephrology (Berlin, Germany), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Ferran CoensDepartment of Pediatric Nephrology and Rheumatology, ERKNet Center, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.ORCID 0009-0007-6678-2542
Dries ReyndersDepartment of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium.
Els GoetghebeurDepartment of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium.
Ineke Tieken, Eurotransplant, Leiden, Netherlands.
Serge Vogelaar, Eurotransplant, Leiden, Netherlands.
Kai KrupkaMedical Faculty, Department of Pediatrics I, Heidelberg University, University Children'S Hospital, 11, Heidelberg, Germany.
Ann RaesDepartment of Pediatric Nephrology and Rheumatology, ERKNet Center, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
Frans Claas, Eurotransplant, Leiden, Netherlands.
Burkhard TönshoffMedical Faculty, Department of Pediatrics I, Heidelberg University, University Children'S Hospital, 11, Heidelberg, Germany.
Agnieszka PrytułaDepartment of Pediatric Nephrology and Rheumatology, ERKNet Center, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium. agnieszka.prytula@uzgent.be.

Funding

AstellasDietmar Hopp StiftungEuropean Society for Pediatric Nephrology (ESPN)German Society for Pediatric Nephrology (GPN)Novartis
6 · The paper itself

Abstract

backgroundRecent reports on allograft survival after repeat kidney transplantation (KTx) and the incidence and determinants of graft failure (GF) are lacking.

methodsWe analyzed the probability of graft failure (GF) and death with functioning graft following a primary pediatric and sequential kidney transplantation (KTx) in 4528 primary, 1155 second, 259 third, and 41 fourth KTx. We calculated the impact of relevant peri-transplant characteristics on the probability of GF and death with functioning graft (as a composite endpoint due to statistical reasons) for specific recipient profiles.

resultsThe respective unadjusted 5-year GF probabilities after first, second, third, and fourth KTx were 15%, 24%, 30%, and 40%, respectively (P < 0.001). The adjusted hazard ratio for the composite endpoint was the highest in the first month after primary transplantation and even higher after subsequent transplantations. After second KTx, older year of transplantation, deceased donor (DD), older donor age, short primary graft survival, PRA 1-100%, and increasing HLA-DR mismatches were associated with a higher predicted outcome. The respective predicted 5-year risks for the outcome in a pediatric DD KTx recipient with 0 and 2 HLA-DR mismatches were 17% and 27% with a 30-year-old DD and 22% and 35% with a 50-year-old DD.

conclusionsGF increased with subsequent KTx. GF and death with a functioning graft after second transplantation improved with calendar year of transplantation, reflecting improvements in transplant care over time. Older donor age, DD KTx, short primary graft survival, high PRA, and increasing HLA-DR mismatch were associated with a higher predicted composite outcome.

Indexed as

Graft RejectionGraft SurvivalKidney TransplantationAdolescentAdultAge FactorsChildChild, PreschoolFemaleHumansIncidenceInfantMaleMiddle AgedReoperationRetrospective StudiesDeath with functioning graftEpidemiologyGraft failureKidney re-transplantationLong-term outcomesPediatric kidney transplantation

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PMID40775406

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