Abstract: SA-PO0686
Pediatric Kidney Transplant Outcomes in Recipients of Kidneys from COVID-19-Positive Donors: Analysis of Data from the Scientific Registry of Transplant Recipients (SRTR)
Session Information
- Pediatric Nephrology: Transplantation, Hypertension, AKI, Genetics, and Developmental Diseases
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1900 Pediatric Nephrology
Authors
- Ranabothu, Saritha, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
- Evans, Michael David, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
- Kizilbash, Sarah J., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
Background
COVID-19 infection is associated with significant morbidity and mortality. However, little is known about kidney transplant outcomes associated with the use of COVID+ donor organs in children.
Methods
We used the Scientific Registry of Transplant Recipients to identify 156 pediatric kidney recipients from 141 COVID + donors (September 2020-December 2024) and matched them to 3,649 pediatric recipients of COVID- donors using a propensity-score-weighting, accounting for patient characteristics presented in Table 1. Patient and graft survival were analyzed using weighted Kaplan-Meier survival curves and log-rank tests
Results
The median follow-up time of the study cohort was 1.2 years [IQR: 0.6, 2.9]. We observed no statistically significant difference in 3-year patient survival (99% vs. 98.4%; p=0.68) and overall graft survival (86.9% vs. 90.9%; p=0.13) between the two groups. However, the difference in 3-year death-censored graft survival approached statistical significance (86.9% vs. 92.3%; p=0.06) (Figure 1).
Conclusion
We observed no significant difference in 3-year patient survival; however, the lower death-censored graft survival among recipients of COVID+ donors approached statistical significance
Patient characteristics
| Variables | COVID- | COVID-(weighted) | COVID+ |
| n | 3649 | 3649 | 156 |
| Effective sample size | 3649 | 2539 | 156 |
| Transplant year-Median (IQR) | 2022 [2021,2024] | 2023 [2022,2024] | 2023[2022,2024] |
| Transplant Age-Median(IQR) | 13 [7,16] | 14 [10,17] | 14[10,17] |
| Male (%) | 59 | 57 | 57 |
| Race (%) | |||
| White | 72 | 62 | 62 |
| Black | 18 | 25 | 25 |
| Asian | 5 | 6 | 6 |
| Other | 5 | 6 | 6 |
| Number of HLA mismatches, Median (IQR) | 4 [3,5] | [4,5] | 5[4,5] |
| Previous Transplant (%) | 8 | 12 | 12 |
| Lymphocyte depletion, induction(%) | 62 | 71 | 71 |
| Tacrolimus(%) | 94 | 96 | 96 |
| Mycophenolate(%) | 93 | 94 | 94 |
| Steroids(%) | 59 | 57 | 57 |