ESPN 51th Annual Meeting

ESPN 2018


 
Comparison of paediatric renal allograft survival and biopsy outcomes between patients with an underlying urological or non-urological diagnosis: A single centre retrospective analysis
JI SOO KIM 1 STEPHEN D MARKS 1

1- GREAT ORMOND STREET HOSPITAL FOR CHILDREN, NHS FOUNDATION TRUST
 
Introduction:

Establish if having an underlying urological diagnosis, which led to end stage kidney disease (ESKD), would result in poorer paediatric renal allograft survival.

Material and methods:

Data from renal transplant, electronic clinical document and pathology result databases at a single tertiary centre enlisted from 2015 were retrospectively reviewed. All paediatric renal transplant recipients (pRTR) had their first renal transplantation at least two years before the date of data compilation. Patients were divided into urological and non-urological groups according to their diagnosis for ESKD.

Results:

n=183 pRTR (60% male) where 60% had an underlying urological diagnosis. 34% of pRTR with a urological cause received a Deceased Donor (DD) allograft whereas 42% among non-urological pRTR. Mean follow-up data available per patient was 65 months (range 1 to 187 months). There was a significant relationship between renal allograft loss and the following biopsy results; Chronic changes (p=0.006), T-cell mediated changes (p=0.002) or Antibody Mediated changes (p=0.001); but not Borderline changes (p=not significant(ns)).  Although male pRTR had significantly more Chronic changes on biopsy (p=0.014), gender did not appear to affect renal allograft survival (p=ns). There was no difference in renal allograft biopsy results between pRTR with a urological or non-urological cause – Normal biopsy (p=ns), Chronic changes (p=ns), T-cell mediated changes (p=ns), Antibody mediated changes (p=ns) or Borderline changes (p=ns). Overall there was no significant difference in renal allograft survival between pRTR with a urological or non-urological diagnosis (p=ns).

Conclusions:

There is an increased likelihood of renal allograft loss in the presence of Chronic, T-cell mediated and Antibody mediated changes as opposed to Borderline changes. However, no significant difference in renal allograft or biopsy outcome was found due to the pRTR having an underlying urological diagnosis.