Access to kidney transplantation and re-transplantation from childhood to adulthood: long-term data from the ERA Registry Article Swipe
Evgenia Preka
,
Marjolein Bonthuis
,
Stephen D. Marks
,
Anneke Kramer
,
Aiko P. J. de Vries
,
Søren Schwartz Sørensen
,
Sevcan A. Bakkaloğlu
,
Claus Bistrup
,
Timo Jahnukainen
,
Olga Lucía Rodriguez Arévalo
,
Lukas Buchwinkler
,
Mårten Segelmark
,
J. Emilio Sánchez-Álvarez
,
Miha Arnol
,
Flor A. Ordóñez-Álvarez
,
Francisco de la Cerda Ojeda
,
Lucy Plumb
,
Shona Methven
,
Runólfur Pálsson
,
Torbjörn Lundgren
,
Héctor F. Ríos
,
Alberto Ortíz
,
Vianda S Stel
,
Jérôme Harambat
,
Kitty J. Jager
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1093/ndt/gfaf025
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1093/ndt/gfaf025
Background and hypothesis Knowledge regarding access to first kidney transplantation (KT) and subsequent KT in patients commencing kidney replacement therapy (KRT) in childhood is limited. Methods Using European Renal Association (ERA) Registry data, we investigated European patients who started KRT below 20 years of age between 1978 and 2019. Access and determinants to first, second, and third KT were assessed using multivariable Cox regression. Results Totals of 12 623, 4077, and 1186 patients were included while awaiting first, second, and third KT, at median ages of 13.8 (IQR: 7.5–17.4), 20.9 (IQR: 16.5–26.1), and 26.6 (IQR: 20.3–32.8) years, respectively. During the study period, overall access was 87.8%, 72.7%, and 60.5% for first, second, and third KT, respectively, and median time to each KT was 0.9 (IQR: 0.2–2.1), 1.9 (0.6–4.5), and 2.6 (IQR: 1.0–5.3) years. Younger age at KRT initiation (aHR 0-4 vs. 10–14 years: 0.54; 95%CI: 0.51–0.57) and female sex (HR: 0.94; 95%CI: 0.90–0.98) were associated with lower access to first KT. KT candidates between 15 and 19 years had lower access to first and second KT (aHR: 0.69; 95%CI: 0.66–0.73, and aHR: 0.70; 95%CI: 0.61–0.81) compared to 10–14 year-olds. Compared to CAKUT, glomerulonephritis patients had lower access to KT (aHR: 0.75; 95%CI: 0.71–0.80 for first, aHR: 0.89; 95%CI: 0.81–0.98 for second, and aHR: 0.80; 95%CI: 0.66–0.97 for third KT). Similarly, patients with primary renal diseases with high risk of recurrence, had lower chances of receiving a first and second KT (aHR: 0.80; 95%CI: 0.76–0.85 for first, aHR: 0.86; 95%CI: 0.78–0.95 for second KT). Access to re-transplantation was also higher with previous pre-emptive KT and previous graft survival exceeding 5 years. Conclusion Our study highlights KT access disparities particularly for females, the youngest recipients, high-risk age (15–19 years), and diseases with recurrence risk. Notably, pre-emptive transplants and enduring previous grafts offer advantages regarding re-transplantation.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/ndt/gfaf025
- OA Status
- green
- References
- 48
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4407398469
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4407398469Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/ndt/gfaf025Digital Object Identifier
- Title
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Access to kidney transplantation and re-transplantation from childhood to adulthood: long-term data from the ERA RegistryWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
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2025Year of publication
- Publication date
-
2025-02-12Full publication date if available
- Authors
-
Evgenia Preka, Marjolein Bonthuis, Stephen D. Marks, Anneke Kramer, Aiko P. J. de Vries, Søren Schwartz Sørensen, Sevcan A. Bakkaloğlu, Claus Bistrup, Timo Jahnukainen, Olga Lucía Rodriguez Arévalo, Lukas Buchwinkler, Mårten Segelmark, J. Emilio Sánchez-Álvarez, Miha Arnol, Flor A. Ordóñez-Álvarez, Francisco de la Cerda Ojeda, Lucy Plumb, Shona Methven, Runólfur Pálsson, Torbjörn Lundgren, Héctor F. Ríos, Alberto Ortíz, Vianda S Stel, Jérôme Harambat, Kitty J. JagerList of authors in order
- Landing page
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https://doi.org/10.1093/ndt/gfaf025Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
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https://www.ncbi.nlm.nih.gov/pmc/articles/12315802Direct OA link when available
- Concepts
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Medicine, Transplantation, Kidney transplantation, Term (time), Pediatrics, Intensive care medicine, Internal medicine, Quantum mechanics, PhysicsTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
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48Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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