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Updated: Apr 11, 2026
05:36
Kidney Procurement in a Preclinical Large Animal Model
Published on: May 2, 2025
846
Pre-emptive pediatric kidney transplantation or not?
C D Garcia1, V B Bittencourt2, R W Rohde2
1Pediatric Nephrology Unit, Departament of Nephrology, Hospital da Criança Santo Antonio, Santa Casa Porto Alegre, Brazil; Nephrology Department, Universidade Federal Ciências da Saude Porto Alegre, Porto Alegre, Brazil.
Transplantation Proceedings
|June 4, 2015
Summary
Pre-emptive kidney transplantation (PKT) offers significant survival benefits for children with end-stage renal disease (ESRD). This study recommends PKT as the preferred option to improve long-term outcomes and reduce ESRD complications.
Area of Science:
- Pediatric Nephrology
- Transplant Surgery
- Immunology
Background:
- Pre-emptive kidney transplantation (PKT) lacks extensive clinical evidence regarding its risks and benefits.
- Previous studies suggest a significant advantage of PKT for end-stage renal disease (ESRD) patients.
- This study investigates characteristics of PKT versus non-pre-emptive kidney transplant (NPKT) recipients.
Purpose of the Study:
- To examine the characteristics of pediatric patients undergoing PKT or NPKT.
- To evaluate the outcomes and survival rates associated with PKT and NPKT in children.
- To provide evidence supporting the recommendation of PKT when feasible.
Main Methods:
- A cohort of 323 pediatric kidney transplant recipients was analyzed.
- Data were collected from patients transplanted between January 2000 and December 2010.
- Graft survival rates were compared between PKT and NPKT groups.
Main Results:
- Congenital anomalies of the kidney and urinary tract (39%) and glomerulopathies (27.5%) were primary causes of ESRD.
- Death-censored graft survival rates at 90 months were 76% for PKT versus 65% for NPKT (P < .05).
- PKT demonstrated a statistically significant survival advantage.
Conclusions:
- Pre-emptive transplantation is associated with improved patient and graft survival (HR=0.37).
- Graft loss causes included disease recurrence (21%), chronic allograft injury (17%), and death with a functioning graft (16%).
- PKT is recommended as a superior option to minimize ESRD morbidity and enhance long-term survival.
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