SP721PAEDIATRIC KIDNEY TRANSPLANT PROGRAM IN KAZAKHSTAN

Venera Altynova, Dinara Galiyeva

2016

Closed access Metadata (CSL-JSON)
DOI 10.1093/ndt/gfw179.28
Data confidence 70 medium
How this score is calculated

It is built from checkable properties of the record itself: whether the article has a DOI, how many independent sources confirmed its data, whether the required fields are filled in, and how recent the latest confirmation is. Disagreement between sources and a missing identifier lower it. A value of 80 or above means the record was published without further checking; 60 to 79 means it is published at reduced confidence, with a manual check advisable. A record verified by an editor by hand is never pushed below 90 by a recalculation. This scores our data about the article, not the article itself.

Abstract

Introduction and Aims: In Kazakhstan the prevalence of renal replacement therapy in children with end stage renal disease (ESRD) was 6 per million of the age-related population in 2013. Kidney transplantation is the best way to reach the medical and social rehabilitation of children with ESRD. Paediatric kidney transplant program in Kazakhstan was launched in 2012 in Astana. The aim of this study is to evaluate the results of the renal transplantation in children in Kazakhstan in the period from 2012 to 2015. Methods: We have conducted a retrospective analysis of the 29 transplanted children under the age of 18 who received kidney transplants in Astana during 2012-2015 years within paediatric kidney transplant program. Results: Mean age of the transplanted children was 11.2 years (Standard Deviation (SD) 3.9). Girls accounted for 69% of all recipients (n=20). The main primary renal diseases which caused ESRD were congenital anomalies of the kidney and urinary tract (44%) and glomerulonephritis (39%). 21 patients (72%) received a kidney transplant of the living donor from their relatives, while 8 children (28%) received a renal transplant from a deceased donor. Median waiting time was 1 year (Interquartile Range 0.5-2.5). Majority of children (47 %) received peritoneal dialysis (PD) before getting transplantation, 28% - haemodialysis (HD), 10% - PD and HD and 15% received pre-emptive transplantation. All children underwent immunosuppressive therapy consisted of induction therapy with monoclonal antibodies (Basiliximab (Simulect)) and Anti-thymocyte immunoglobulin (Thymoglobuline) and primary therapy with Calcineurin inhibitors (Tacrolimus or Cyclosporine), Mycophenolic acid (Cell-Cept) and glucocorticoids (Prednisolone or Methylprednisolone). Surgery complications after kidney transplantation were in 6 children (21%). Out of them 4 patients experienced chylorrhea, 1 child had the failure of the ureter (necrosis) and another child had bleeding. Mean follow-up time was 1.4 years (SD 0.9) resulting in total of 43 patient-years. Two patients died (7%). Mortality rate was 4.7 per 100 patient-years. Graft loss occurred in one child. Eight patients had graft dysfunction, the causes of which in most cases was infection (4 children). One-year patient and graft survival was 94% and 97% respectively. Three-year patient and graft survival was 95% и 85% respectively.