Abstract: TH-PO950

Time to Second Kidney Transplantation after Failed Pediatric Kidney Transplant: A Retrospective Cohort Analysis

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Phonphok, Korntip, UCLA, Los Angeles, California, United States
  • Cho, Yong W, Mendez National Institution of Transplantation, Los Angeles, California, United States
  • Bunnapradist, Suphamai, UCLA, Los Angeles, California, United States
Background

With the prioritization of age ≤ 18 years old at time of registration on the kidney transplant waiting list, deceased donor rates have increased. Majority of these patients require subsequent transplantation at later time. Waiting periods before re-transplantation may vary in length, depend on donor type, PRA, and HLA mismatch. We hypothesized that candidates of those after failed first pediatric DDKT would have greater time to subsequent KT than those after failed first living donor KT (LDKT).

Methods

We used data from the Organ Procurement Transplant Network (OPTN/UNOS) as of December 8, 2016. A retrospective cohort analysis was created to examine time to second KT in 1,935 candidates listed at age 18-30 from January 1, 2000 to September 30, 2015 with previous KT at age ≤ 18. Those with > 2 KT episodes or multiorgan transplant were excluded. Patients were divided into 2 groups according to donor type of first KT; 1) those with failed first DDKT and 2) those with failed first LDKT.

Results

Median time to second KT were 646.5 days and 412.0 days in those candidates with failed first DDKT and those with failed first LDKT, respectively. (p<0.01) First LDKT recipients were more likely to have subsequent LDKT than those with failed DDKT. Median PRA were 85% and 68% (p<0.01), and high PRA (PRA≥98%) were found 26.0% and 16.0% (p<0.01) in recipients of second KT after failed first DDKT and those after failed first LDKT, respectively.

Conclusion

Candidates with previously failed pediatric DDKT had significant greater time to subsequent KT than those with failed first LDKT as well as higher PRA value. Pediatric KT recipients prioritize DDKT in the past could face a challenge with greater waiting time and PRA before re-transplantation.