Laparoscopic live donor nephrectomy: A risk factor for delayed function and rejection in pediatric kidney recipients? A UNOS analysis

Christoph Troppmann, Maureen A. McBride, Timothy J. Baker, Richard V Perez

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54 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)175-182
Number of pages8
JournalAmerican Journal of Transplantation
Volume5
Issue number1
DOIs
StatePublished - Jan 2005

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Nephrectomy
Tissue Donors
Pediatrics
Kidney
Delayed Graft Function
Graft Survival
Dialysis
Multivariate Analysis
Age Groups
Databases

Keywords

  • Delayed graft function
  • Laparoscopic nephectomy
  • Live kidney donor
  • Open nephrectomy
  • Pediatric kidney transplantation
  • Rejection

ASJC Scopus subject areas

  • Immunology

Cite this

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title = "Laparoscopic live donor nephrectomy: A risk factor for delayed function and rejection in pediatric kidney recipients? A UNOS analysis",
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.",
keywords = "Delayed graft function, Laparoscopic nephectomy, Live kidney donor, Open nephrectomy, Pediatric kidney transplantation, Rejection",
author = "Christoph Troppmann and McBride, {Maureen A.} and Baker, {Timothy J.} and Perez, {Richard V}",
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T2 - A risk factor for delayed function and rejection in pediatric kidney recipients? A UNOS analysis

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AU - McBride, Maureen A.

AU - Baker, Timothy J.

AU - Perez, Richard V

PY - 2005/1

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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.

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KW - Rejection

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