Abstract
The impact of laparoscopic (vs. open) donor nephrectomy on early graft function and survival in pediatric kidney recipients (≤18 years) is unknown. We studied 995 pediatric live donor txs reported to UNOS from January 2000 to June 2002, in two recipient age groups: 0-5 years (n = 212, 44% laparoscopic donors [LapD]) and 6-18 years (n = 783, 50% LapD). Delayed graft function (DGF) rates were higher for LapD versus open donor (OpD) txs (0-5 years, 12.8% vs. 2.5% [p = 0.004]; 6-18 years, 5.9% vs. 2.8% [p = 0.03]). Acute rejection incidence for LapD versus OpD txs was higher at 6 months for recipients 0-5 years (18.6% vs. 5.9%, p = 0.01) and 6-18 years (22.5% vs. 15.6%, p = 0.03), and 1 year for recipients 0-5 years (24.3% vs. 7.9%, p = 0.004). In multivariate analyses, significant independent risk factors for rejection at 6 months and 1 year were recipient age 6-18 years, pretx dialysis, LapD nephrectomy and DGF. Graft survival was similar for LapD versus OpD txs. In this retrospective UNOS database analysis, LapD procurement was associated with increased DGF and an independent risk factor for rejection during the first year, particularly for recipients 0-5-years old. Future investigations must confirm these findings and identify strategies to optimize procurement and pediatric recipient outcome.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 175-182 |
| Number of pages | 8 |
| Journal | American Journal of Transplantation |
| Volume | 5 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2005 |
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Keywords
- Delayed graft function
- Laparoscopic nephectomy
- Live kidney donor
- Open nephrectomy
- Pediatric kidney transplantation
- Rejection
ASJC Scopus subject areas
- Immunology
Cite this
Laparoscopic live donor nephrectomy : A risk factor for delayed function and rejection in pediatric kidney recipients? A UNOS analysis. / Troppmann, Christoph; McBride, Maureen A.; Baker, Timothy J.; Perez, Richard V.
In: American Journal of Transplantation, Vol. 5, No. 1, 01.2005, p. 175-182.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Laparoscopic live donor nephrectomy
T2 - A risk factor for delayed function and rejection in pediatric kidney recipients? A UNOS analysis
AU - Troppmann, Christoph
AU - McBride, Maureen A.
AU - Baker, Timothy J.
AU - Perez, Richard V
PY - 2005/1
Y1 - 2005/1
N2 - The impact of laparoscopic (vs. open) donor nephrectomy on early graft function and survival in pediatric kidney recipients (≤18 years) is unknown. We studied 995 pediatric live donor txs reported to UNOS from January 2000 to June 2002, in two recipient age groups: 0-5 years (n = 212, 44% laparoscopic donors [LapD]) and 6-18 years (n = 783, 50% LapD). Delayed graft function (DGF) rates were higher for LapD versus open donor (OpD) txs (0-5 years, 12.8% vs. 2.5% [p = 0.004]; 6-18 years, 5.9% vs. 2.8% [p = 0.03]). Acute rejection incidence for LapD versus OpD txs was higher at 6 months for recipients 0-5 years (18.6% vs. 5.9%, p = 0.01) and 6-18 years (22.5% vs. 15.6%, p = 0.03), and 1 year for recipients 0-5 years (24.3% vs. 7.9%, p = 0.004). In multivariate analyses, significant independent risk factors for rejection at 6 months and 1 year were recipient age 6-18 years, pretx dialysis, LapD nephrectomy and DGF. Graft survival was similar for LapD versus OpD txs. In this retrospective UNOS database analysis, LapD procurement was associated with increased DGF and an independent risk factor for rejection during the first year, particularly for recipients 0-5-years old. Future investigations must confirm these findings and identify strategies to optimize procurement and pediatric recipient outcome.
AB - The impact of laparoscopic (vs. open) donor nephrectomy on early graft function and survival in pediatric kidney recipients (≤18 years) is unknown. We studied 995 pediatric live donor txs reported to UNOS from January 2000 to June 2002, in two recipient age groups: 0-5 years (n = 212, 44% laparoscopic donors [LapD]) and 6-18 years (n = 783, 50% LapD). Delayed graft function (DGF) rates were higher for LapD versus open donor (OpD) txs (0-5 years, 12.8% vs. 2.5% [p = 0.004]; 6-18 years, 5.9% vs. 2.8% [p = 0.03]). Acute rejection incidence for LapD versus OpD txs was higher at 6 months for recipients 0-5 years (18.6% vs. 5.9%, p = 0.01) and 6-18 years (22.5% vs. 15.6%, p = 0.03), and 1 year for recipients 0-5 years (24.3% vs. 7.9%, p = 0.004). In multivariate analyses, significant independent risk factors for rejection at 6 months and 1 year were recipient age 6-18 years, pretx dialysis, LapD nephrectomy and DGF. Graft survival was similar for LapD versus OpD txs. In this retrospective UNOS database analysis, LapD procurement was associated with increased DGF and an independent risk factor for rejection during the first year, particularly for recipients 0-5-years old. Future investigations must confirm these findings and identify strategies to optimize procurement and pediatric recipient outcome.
KW - Delayed graft function
KW - Laparoscopic nephectomy
KW - Live kidney donor
KW - Open nephrectomy
KW - Pediatric kidney transplantation
KW - Rejection
UR - http://www.scopus.com/inward/record.url?scp=11844277053&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=11844277053&partnerID=8YFLogxK
U2 - 10.1111/j.1600-6143.2004.00661.x
DO - 10.1111/j.1600-6143.2004.00661.x
M3 - Article
C2 - 15636627
AN - SCOPUS:11844277053
VL - 5
SP - 175
EP - 182
JO - American Journal of Transplantation
JF - American Journal of Transplantation
SN - 1600-6135
IS - 1
ER -