Abstract: SA-PO0690
Childhood Opportunity Index and Pediatric Kidney Transplantation: A NAPRTCS and PHIS Study
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
- Benz, Eric, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
- Kizilbash, Sarah J., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
- Ranabothu, Saritha, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
- Douglas, Chloe E., Oregon Health & Science University, Portland, Oregon, United States
- Boynton, Sara Ashley, Johns Hopkins Medicine, Baltimore, Maryland, United States
- Grills, Natalie K, Children's Hospital Association, Overland Park, Kansas, United States
- Dutta, Sreejata, Children's Hospital Association, Overland Park, Kansas, United States
- Richardson, Troy, Children's Hospital Association, Overland Park, Kansas, United States
- Smith, Jodi M., University of Washington System, Seattle, Washington, United States
- Bock, Margret, University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States
Group or Team Name
- North American Pediatric Renal Trials Collaborative Studies, Pediatric Health Information System.
Background
Disparities in access to & outcomes after pediatric kidney transplantation (pKT) exist & are more prevalent in certain sociodemographic groups. The Childhood Opportunity Index 3.0 (COI) uses neighborhood-level factors to measure & map resources available to children in the United States. We aimed to describe characteristics of pKT recipients by COI & investigate associations between COI & pKT outcomes.
Methods
We performed a retrospective study linking pKTs (2012-2023) from the North American Pediatric Renal Trials & Collaborative Studies (NAPRTCS) registry to Pediatric Health Information System (PHIS) data. Patient ZIP Codes were categorized by COI z-score: low COI (quintiles 1-2, lower resourced) & high COI (quintiles 3-5, higher resourced). We performed exploratory analyses to examine associations of COI with pKT outcomes.
Results
We analyzed 1,110 pKTs. Compared to recipients with higher COI, pKT recipients with lower COI lived in non-urban areas more often (33.1 vs 8.3%, p<0.05), traveled farther to transplant centers (median: 44.5 vs 23.4 miles, p<0.05), underwent re-transplantation more often (28.2 vs 22%, p<0.05), & received KTs from living donors (LD) less often (31.6 vs 47%, p<0.05). There were no differences across COI groups for estimated Glomerular Filtration Rate (eGFR) at 1, 3 & 5 years post KT, or prevalence of pre-KT dialysis. (Table 1)
Conclusion
COI is a useful tool in assessing sociodemographic disparities among & differences in access to LD in pKT recipients. We have identified lower access to LD & more common need for re-transplantation in pKT recipients with lower COI as potentially modifiable opportunities requiring thoughtful resource (re)allocation within local & national communities.