Mp72-08 Predictive Factors for Allograft Rejection in Pediatric Renal Transplant Patients

You have accessJournal of UrologyPediatrics VII (MP72)1 May 2024MP72-08 PREDICTIVE FACTORS FOR ALLOGRAFT REJECTION IN PEDIATRIC RENAL TRANSPLANT PATIENTS Adam Fisher, Ala'a Farkouh, Kai Wen Cheng, Ruby Kuang, Sikai Song, Vinicius Seidel, Matthew Buell, David Chamberlin, and Joshua Chamberlin Adam FisherAdam Fisher , Ala'a FarkouhAla'a Farkouh , Kai Wen ChengKai Wen Cheng , Ruby KuangRuby Kuang , Sikai SongSikai Song , Vinicius SeidelVinicius Seidel , Matthew BuellMatthew Buell , David ChamberlinDavid Chamberlin , and Joshua ChamberlinJoshua Chamberlin View All Author Informationhttps://doi.org/10.1097/01.JU.0001009572.60675.69.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Many factors influence the success of renal allograft longevity in children. Infection rates are increased in immunocompromised children after transplantation. We sought to investigate clinical factors that influence allograft rejection. We hypothesize that VUR and UTI following renal transplantation negatively affect allograft function and longevity. The purpose of this study was to identify factors predictive for allograft rejection in pediatric renal transplantation. METHODS: A retrospective review of all pediatric renal transplant patients at a single transplant center from 2013 to 2022 was performed. Patients less than 18 years of age who underwent initial renal transplantation for end stage renal disease were included. Patients with less than 6 months of follow-up were excluded. Clinical data was collected, including etiology of renal failure, presence of VUR, and UTI defined as pyuria and single organism culture with >100,000 cfu/mL. Severe UTI was defined as UTI with fever or requiring hospital admission. Rejection was determined by allograft biopsy using the Banff classification. The primary endpoint was development of allograft rejection. Statistical comparisons were made using Fisher's exact test, with p<0.05 considered significant. RESULTS: A total of 79 children underwent renal transplantation. The cause of primary renal failure included renal etiology in 60 children (75.9%) and bladder etiology in 19 children (24.1%). A total of 34 (43.0%) patients had biopsy-proven allograft rejection,16 (47.1%) Banff 1, 10 (29.4%) Banff 2, and 8 (23.5%) unclassified rejection. Severe UTI was diagnosed in 5 children (6.3%) after renal transplant, and all developed allograft rejection (p=0.012). Post-transplant VUR was diagnosed in 9 patients (11.4%) but was not associated with the development of allograft rejection (p=0.16). Post-transplant VUR was diagnosed in 9 patients (11.4%); this cohort had higher incidence of severe UTI compared to those without VUR (33.3% vs 2.8%; p=0.009). Etiology of renal failure, onset time of initial renal failure, and non-severe UTIs were not associated with allograft rejection. CONCLUSIONS: Post-transplant VUR was associated with increased risk of severe UTI. Severe UTI was associated with allograft rejection. Identification, prevention and treatment of VUR and UTI in children with renal transplantation may improve the longevity of the renal allograft. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1174 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Adam Fisher More articles by this author Ala'a Farkouh More articles by this author Kai Wen Cheng More articles by this author Ruby Kuang More articles by this author Sikai Song More articles by this author Vinicius Seidel More articles by this author Matthew Buell More articles by this author David Chamberlin More articles by this author Joshua Chamberlin More articles by this author Expand All Advertisement PDF downloadLoading ...