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Robot-Assisted Kidney Transplantation
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Setting reasonable objectives for improving preemptive kidney transplantation rates in children
Cyrielle Parmentier1,2, Mathilde Lassalle3, Etienne Berard4
1Pediatric Nephrology Unit, Armand Trousseau Hospital, APHP.6, 75012, Paris, France. cyrielle.parmentier@aphp.fr.
Pediatric Nephrology (Berlin, Germany)
|June 26, 2020
Summary
A new method identified 37% of pediatric kidney transplant patients as suitable for preemptive kidney transplantation (PKT) but received non-preemptive kidney transplantation (NPKT). This highlights a significant potential to increase PKT rates in children.
Area of Science:
- Pediatric Nephrology
- Transplantation Immunology
- Health Services Research
Background:
- Preemptive kidney transplantation (PKT) offers better outcomes than non-preemptive kidney transplantation (NPKT) following dialysis.
- Identifying suitable candidates for PKT is crucial for optimizing kidney transplant access.
- Many patients eligible for PKT initiate kidney replacement therapy (KRT) on dialysis.
Purpose of the Study:
- To develop and apply a method for estimating the potential for PKT in pediatric patients.
- To identify children who initiated KRT via NPKT despite being medically suitable for PKT.
Main Methods:
- Utilized French National Health Insurance data for children starting KRT (2010-2016).
- Estimated propensity scores for PKT based on recipient medical characteristics.
- Defined sufficient pre-KRT follow-up (>18 months) as eligibility for PKT.
Main Results:
- 149 out of 643 (23.2%) pediatric patients received PKT.
- Among 391 NPKT patients, 145 (37%) were identified as suitable for PKT.
- 79 NPKT patients with >18 months pre-KRT follow-up were suitable for PKT.
Conclusions:
- An estimated 228 (35%) pediatric kidney transplants in France could potentially be preemptive.
- The developed method can inform health policy for improving PKT access.
- This approach is adaptable for adult populations and other countries.
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