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Access to kidney transplantation and re-transplantation from childhood to adulthood: long-term data from the ERA Registry

dc.rights.licenseopenen_US
dc.contributor.authorPREKA, Evgenia
dc.contributor.authorBONTHUIS, Marjolein
dc.contributor.authorMARKS, Stephen D
dc.contributor.authorKRAMER, Anneke
dc.contributor.authorDE VRIES, Aiko P J
dc.contributor.authorSORENSEN, Soren S
dc.contributor.authorBAKKALOGLU, Sevcan A
dc.contributor.authorBISTRUP, Claus
dc.contributor.authorJAHNUKAINEN, Timo
dc.contributor.authorAREVALO, Olga L Rodriguez
dc.contributor.authorBUCHWINKLER, Lukas
dc.contributor.authorSEGELMARK, Marten
dc.contributor.authorSANCHEZ, J Emilio
dc.contributor.authorARNOL, Miha
dc.contributor.authorORDONEZ-ALVAREZ, Flor A
dc.contributor.authorDE LA CERDA-OJEDA, Francisco
dc.contributor.authorPLUMB, Lucy A
dc.contributor.authorMETHVEN, Shona
dc.contributor.authorPALSSON, Runolfur
dc.contributor.authorLUNDGREN, Torbjorn
dc.contributor.authorRIOS, Hector
dc.contributor.authorORTIZ, Alberto
dc.contributor.authorSTEL, Vianda S
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorHARAMBAT, Jerome
dc.contributor.authorJAGER, Kitty J
dc.date.accessioned2025-04-11T08:09:20Z
dc.date.available2025-04-11T08:09:20Z
dc.date.issued2025-02-12
dc.identifier.issn1460-2385en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/206129
dc.description.abstractEnBACKGROUND AND HYPOTHESIS: Knowledge regarding access to first kidney transplantation (KT) and subsequent KT in patients commencing kidney replacement therapy (KRT) in childhood is limited. METHODS: Using European Renal Association (ERA) Registry data, we investigated European patients who started KRT below 20 years of age between 1978 and 2019. Access and determinants to first, second and third KT were assessed using multivariable Cox regression. RESULTS: 12 623, 4077, and 1186 patients were included while awaiting first, second and third KT, at median ages of 13.8 (IQR: 7.5-17.4), 20.9 (IQR: 16.5-26.1) and 26.6 (IQR: 20.3-32.8) years, respectively. During the study period, overall access was 87.8%, 72.7% and 60.5% for first, second and third KT, respectively, and median time to each KT was 0.9 (IQR: 0.2-2.1), 1.9 (0.6-4.5) and 2.6 (IQR: 1.0-5.3) years. Younger age at KRT initiation (aHR 0-4 vs. 10-14 years: 0.54; 95%CI: 0.51-0.57) and female sex (HR: 0.94; 95%CI: 0.90-0.98) were associated with lower access to first KT. KT candidates between 15-19 years had lower access to first and second KT (aHR: 0.69; 95%CI: 0.66-0.73, and aHR: 0.70; 95%CI: 0.61-0.81) compared to 10-14 year-olds. Compared to CAKUT, glomerulonephritis patients had lower access to KT (aHR: 0.75; 95%CI: 0.71-0.80 for first, aHR: 0.89; 95%CI: 0.81-0.98 for second and aHR: 0.80; 95%CI: 0.66-0.97 for third KT). Similarly, patients with primary renal diseases with high risk of recurrence, had lower chances of receiving a first and second KT (aHR: 0.80; 95%CI: 0.76-0.85 for first, aHR: 0.86; 95%CI: 0.78-0.95 for second KT). Access to re-transplantation was also higher with prior pre-emptive KT and previous graft survival exceeding five years. CONCLUSION: Our study highlights KT access disparities particularly for females, the youngest recipients, high-risk age (15-19 years), and diseases with recurrence risk. Notably, pre-emptive transplants and enduring previous grafts offer advantages regarding re-transplantation.
dc.language.isoENen_US
dc.subject.enEpidemiology
dc.subject.enHigh-Risk Age Window
dc.subject.enKidney Transplant Candidates
dc.subject.enKidney Transplantation
dc.subject.enPaediatric
dc.subject.enRetransplantation
dc.title.enAccess to kidney transplantation and re-transplantation from childhood to adulthood: long-term data from the ERA Registry
dc.title.alternativeNephrol Dial Transplanten_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1093/ndt/gfaf025en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed39938931en_US
bordeaux.journalNephrology Dialysis Transplantationen_US
bordeaux.pagegfaf025en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamLEHA_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-05030363
hal.version1
hal.date.transferred2025-04-11T08:09:26Z
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
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