Does allograft failure impact school attendance in children? A NAPRTCS study

Area of Science:

• Pediatric Nephrology
• Transplantation Immunology
• Quality of Life Research

Background:

• Adult dialysis patients with allograft failure face higher mortality and morbidity.
• Previous studies indicated comparable mortality in pediatric patients post-allograft failure, but morbidity impact, especially on school attendance, remained unclear.

Purpose of the Study:

• To investigate the impact of allograft failure on school attendance in pediatric dialysis patients.
• To compare school attendance between pediatric patients with previous allograft failure and those who are transplant-naïve.

Main Methods:

• Utilized the North American Pediatric Renal Trials and Collaborative Studies database (1992-2007).
• Compared school attendance at 6 and 12 months post-dialysis initiation using chi-square tests.
• Employed multivariate logistic regression to analyze factors affecting school attendance.

Main Results:

• Analyzed 2783 pediatric patients (576 with allograft failure, 2207 transplant-naïve).
• At 6 months, full-time school attendance was 67.2% (allograft failure) vs. 72.3% (transplant-naïve) (P=0.0164).
• After adjustment, allograft failure did not significantly impact school attendance at 6 or 12 months (HR 1.12, CI 0.91-1.39; HR 0.99, CI 0.78-1.27).

Conclusions:

• Pediatric patients with failed allografts returning to dialysis have comparable school attendance to transplant-naïve counterparts.
• Allograft failure is not an adverse prognostic factor for quality of life, as assessed by full-time school attendance.