Abstract: PO2143
Clinical Outcome After Combined Liver and Kidney Transplantation in Children in Europe: A CERTAIN Registry Analysis
Session Information
- Transplantation: Clinical - Underrecognized Risk Factors, Traditional Considerations, and Outcomes
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Brinkert, Florian, Universitatsklinikum Hamburg Eppendorf Klinik fur Kinder- und Jugendmedizin, Hamburg, Hamburg, Germany
- Gorontzi, Katja, Universitatsklinikum Hamburg Eppendorf Klinik fur Kinder- und Jugendmedizin, Hamburg, Hamburg, Germany
- Bacchetta, Justine, Hospices Civils de Lyon, Lyon, Auvergne-Rhône-Alpes , France
- Büscher, Anja K., Universitatsklinikum Essen Klinik fur Kinderheilkunde II, Essen, Nordrhein-Westfalen, Germany
- Dello Strologo, Luca, Ospedale Pediatrico Bambino Gesu, Roma, Lazio, Italy
- Kelly, Deirdre, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, Birmingham, United Kingdom
- Kemper, Markus J., Asklepios Kliniken Hamburg GmbH Asklepios Klinik Nord Standort Heidberg, Hamburg, Hamburg, Germany
- Pape, Lars, Universitatsklinikum Essen Klinik fur Kinderheilkunde II, Essen, Nordrhein-Westfalen, Germany
- Szymczak, Marek, Instytut Pomnik -Centrum Zdrowia Dziecka, Warszawa, Poland
- Toenshoff, Burkhard, Universitatsklinikum Heidelberg Zentrum fur Kinder und Jugendmedizin, Heidelberg, Baden-Württemberg, Germany
- Oh, Jun, Universitatsklinikum Hamburg Eppendorf Klinik fur Kinder- und Jugendmedizin, Hamburg, Hamburg, Germany
Background
Combined liver and kidney transplantation (CLKT) in children is still a challenging procedure and therefore performed only in specialized centers. Outcome of these patients is mostly published as single center reports. To gain more insights in outcome and specific challenges of this rare disease group we aimed for an European registry analysis.
Methods
We conducted a multi-center, retrospective, cohort study using data of the Cooperative European Pediatric Renal Transplant Initiative (CERTAIN) registry (www.certain-registry.eu). The CERTAIN registry provides transplantation-related data of kidney allograft recipients ≤ 21 years at transplantation of 75 pediatric renal transplant centers in Europe. For this specific study we established an additional dataset for liver allograft recipients which includes essential liver transplantation-related data. The survival curves were assessed with the Kaplan-Meier method and compared with the log-rank- test. The statistical analyses were performed with SPSS, Version 27.
Results
Included in the study were 159 patients from 13 transplantation centers. The diagnosis leading to transplantation was primary hyperoxaluria type 1 (PH1) in 64 patients, in 70 patients autosomal recessive polycystic kidney disease (ARPKD), and in 25 patients various other diagnoses. The median follow-up time was 3.9 years (range, 5 days-17 years). Patient survival was good with 9 deaths reported. This led to an overall patient survival of 94% with no difference between PH1 and ARPKD. The kidney and liver graft survival rates were 92.5% and 91.1%, respectively. Long-term eGFR calculations showed stable renal function until 9 years of follow-up. Thereafter, kidney function slowly deteriorates. Liver function tests were stable over the whole study period.
Conclusion
CERTAIN registry data showed that CLKT lead to an excellent patient and organ survival with no difference between PH1 and ARPKD patients. In addition, patient survival after CLKT is comparable to isolated liver or kidney transplantation. The retrospective study design may have led to a reporting bias.