Mp55-17 Early Results of a Pediatric Transplant Program During Wartime in Ukraine: A Cohort Study

You have accessJournal of UrologyPediatrics IV (MP55)1 May 2024MP55-17 EARLY RESULTS OF A PEDIATRIC TRANSPLANT PROGRAM DURING WARTIME IN UKRAINE: A COHORT STUDY Rostyslav Nakonechnyy, Dmytro Shevchuk, Andrii Nakonechnyi, Andriy Kuzyk, and Taras Vivcharivskyi Rostyslav NakonechnyyRostyslav Nakonechnyy , Dmytro ShevchukDmytro Shevchuk , Andrii NakonechnyiAndrii Nakonechnyi , Andriy KuzykAndriy Kuzyk , and Taras VivcharivskyiTaras Vivcharivskyi View All Author Informationhttps://doi.org/10.1097/01.JU.0001008616.01808.0f.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Access to renal transplantation in children with severe chronic kidney disease can be endangered in dangerous sociopolitical environments. Despite such challenges, we established the very first adult and pediatric renal transplantation program in Ukraine in 2021 during an ongoing war and the COVID-19 pandemic, which caused significant delays and difficulties, including disrupted supply chains and shortages of critical medical supplies and equipment and availability and access to transplant resources and personnel. Here, we describe our experience with establishing and conducting a pediatric renal transplantation program during wartime and a pandemic in Ukraine. METHODS: We conducted a retrospective cohort study of 20 pediatric patients who underwent renal transplantation between January 2021 and September 2023 at two large-volume pediatric care centers in Lviv. Due to Ukrainian laws, donations could not be taken from soldiers and military personnel or civilians who suffered due to hostilities. We managed immunosuppressive medications and antibiotic prophylaxis or treatment post-transplant, and nearly all patients were on dialysis prior to transplantation. RESULTS: Our program constituted 23% (189/821) of all transplants performed in Ukraine in the last three years, and we have expanded our efforts to Western Ukraine. The majority of our patients did not undergo native nephrectomy, and most patients were on dialysis prior to transplantation. Average age at the time of transplant was 12.6 +4.5 (years), and average length of time on dialysis was 18 months. Overall, 30-day graft survival was 95%. Two patients experienced acute rejection that was successfully managed medically, while one had graft thrombosis requiring nephrectomy on the day of surgery. CONCLUSIONS: Despite the challenges of establishing a renal transplantation program during wartime and the impact of COVID-19, we have successfully started a pediatric renal transplantation program in Ukraine with a 95% 30-day graft survival rate. Our efforts have constituted 23% of all transplants performed in Ukraine in the last three years, and we have expanded our program to Western Ukraine. Our experience highlights the importance of access to necessary care in challenging environments and the need for continued support and collaboration in these settings. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e923 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Rostyslav Nakonechnyy More articles by this author Dmytro Shevchuk More articles by this author Andrii Nakonechnyi More articles by this author Andriy Kuzyk More articles by this author Taras Vivcharivskyi More articles by this author Expand All Advertisement PDF downloadLoading ...