Changing trends in pediatric transplantation: 2001 Annual Report of the North American Pediatric Renal Transplant Cooperative Study

TLDR

The North American Pediatric Renal Transplant Cooperative Study has collected clinical data on pediatric kidney transplants since 1987 across more than 150 centers in the United States, Canada, Mexico, and Costa Rica. The report analyzes 7,545 transplants in 6,878 patients from 1987 to 2001. The analysis shows growing minority transplant rates, markedly better acute rejection outcomes, and comparable one‑year graft survival across donor types and ages, yet persistent disparities in African American and adolescent patients, chronic rejection, and immunosuppression complications.

Abstract

Abstract: The North American Pediatric Renal Transplant Cooperative Study has collected clinical information on children undergoing a renal transplantation since 1987. This cooperative group now includes over 150 participating medical centers in the United States, Canada, Mexico, and Costa Rica. This report covers the years from 1987 through 2001 and includes data on 7545 renal transplants in 6878 patients. This report demonstrates changing trends in many areas of pediatric transplantation including increasing numbers of African American and Hispanic children receiving transplantation, remarkable improvements in the rate of acute rejection, rejection reversal, and short‐ and long‐term allograft survival. In the most recent cohorts of patients, we now see that 1‐yr allograft survival is no different in cadaver donor compared to living donor recipients and in infants compared to all other age groups. However, this analysis also reveals areas of continued challenges including inferior outcomes in African American and adolescent populations, chronic rejection, and the adverse effects of immunosuppression.