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Kidney Outcomes 1

Monday September 23, 2024 - 10:40 to 12:10

Room: Beyazıt

220.9 Long-term outcome of pediatric kidney transplant recipients: A single-center experience

Dalia Obeid, Saudi Arabia

Assistant scientist
Transplant Research & Innovation Department, Organ Transplant Centre of Excellence
King Faisal Specialist Hospital & Research Centre

Abstract

Long-term outcome of pediatric kidney transplant recipients: A single-center experience

Dalia Obeid1, Ayodele Alaiya2,4, Rezgah Aldhafiry 3,4, Weiam Almaiman 3, Enaam Karar 3, Sulaiman Alrddadi 3, Khalid Alhasan 3, Ali Tariq3, Dieter Broering1,4, Hamad Almojalli3.

1Transplant Research and Innovation Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 2Stem Cell Therapy Program, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 3Kidney and Pancreas Health Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 4College of Medicine, Alfaisal University, Riyadh, Saudi Arabia

Background: The outcome of pediatric Kidney transplantation (KT) in Saudi Arabia is not well documented. KT in pediatric patients lacks predictive markers to monitor rejection. Our study investigated the outcomes of kidney transplantation in pediatric patients and identified risk factors for acute allograft rejection, chronic allograft rejection, and graft loss.
Methods: This study is a retrospective study of all pediatric patients at a specialized hospital in Riyadh, Saudi Arabia. All patients aged 1 to 17 who underwent kidney transplants between September 2005 and June 2022 were included in this study. Clinical and demographical data were collected from the hospital's clinical record system. A total of 174 patients were included for the study.  
Results: In our cohort, the most common pediatric end-stage Kidney diseases were obstructive uropathy (~11%), followed by congenital nephrotic syndrome (CNS) (~10%), multicystic dysplastic kidney (MCDK) (8%), and Focal segmental glomerulosclerosis (FSGS) (7%).

A total of 49/174 (28.2%) of the cases were confirmed pathologically for acute rejection (AR), and 12/174 (6.9%) had chronic rejection. Acute rejection and multiple episodes of rejection were associated with age and multiple opportunistic infections. In our cohort, age was a significant predictor for acute rejection, with reduced risk for patients’ age under five years (HR: 0.16 (95%CI: 0.04-0.58)), while triple risk was documented for patients with multiple opportunistic infections (HR=3.32, 95%CI: 1.33-8.28). Overall, our cohort's survival rate free of acute rejection was at 90%, 82%, and 81% after 1, 3, and 5 years. In contrast, survival-free graft loss was 100%, 99%, and 94% after 1, 5, and 10 years respectively.

Conclusions: In conclusion, pediatric kidney recipients in our center showed an overall improved outcome. In our study, we confirm the importance of recipient age at the operation, and the importance of monitoring transplantation for rejection markers and infections, as they can significantly affect graft and patient survival.

Presentations by Dalia Obeid

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