Abstract: TH-PO949

Results of a Pediatric Transplant Program in a Low Income Country: 10 years of Guatemalan Experience

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Aguilar, Angie Lizet, FUNDANIER, Guatemala, Guatemala
  • Soveranis, Sindy, FUNDANIER, Guatemala, Guatemala
  • Reyes, Edgar Edgar, Hospital Roosevelt, Guatemala, Guatemala
  • Lou-Meda, Randall M, FUNDANIER, Guatemala, Guatemala
Background

ESRD rates appear to be increasing for many developing countries,becoming more challenging to get access to Renal Replacement Therapy and transplant in particular. Guatemala, situated in Central America, has an incidence of ESRD in children of 4.6 pmarp and a transplant rate of 6.9 pmp including children and adults. FUNDANIER (Foundation for Children with Kidney Diseases) has become the only center that provides free access to RRT to Guatemalan Children and during the last decade has performed and follow up close to 80 transplants. Hereby we analyzed our program database

Methods

We retrospectively described the results of all transplanted patients between 2007 and 2017. Data including demographic characteristics of recipients and donors were obtained from FUNDANIER data base. Variables like immunosuppression, reasons for discharge of the program, graft loss causes, No. of rejections, acute complications, patient and graft survival at 1 year were analyzed

Results

78 patients were transplanted. The mean age was 12.6ys(SD3.12),54% were male and the etiology of ESRD was unknown in 65%, followed by CAKUT in 21% of patients. Regarding donors, the mean age was 33ys(SD7.62) and 37% were male. Most of the donations were from living donors (88%). The maintenance immunosuppression used in 91%(n=71) of the patients was Tacrolimus, Mycophenolate and Prednisone. The most common acute complication after transplant was infections (19%). In total 26% of patients (18/70) experience at least 1episode of rejection after 12mo post transplant. Of 43 episodes of rejection reported, 53%(23/43) were after 1year post transplant. The mean time of follow up was 3.5 years (SD1.97).8(23%) patients discharged from the program were moved to other type of RRT due to graft loss. The patient and graft survival at 1 year was 89% and 88%. When divided by type of donation, the 1year graft survival for living and deceased donor was 89% and 70%

Conclusion

After the first decade of the program this is the 1st analysis. Most of the transplants are from young and living donors. Increasing the number of deceased donor is mandatory in order to improve the transplant rate in a country with a high rate of ESRD with unknown etiology. The overall graft survival is 88% at 1 year. The main cause of graft loss is rejection due to poor compliance and acute vascular complications