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Updated: Jul 10, 2025
Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
Life after a pediatric kidney transplant
Julia Fijo1, Ana Sánchez-Moreno1
1Unidad de Nefrología Pediátrica, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain.
Insights
Pediatric kidney transplant recipients show improved survival and graft success, especially with living donors. However, long-term adult outcomes reveal challenges in education and social support, impacting overall quality of life.
Area of Science:
- Pediatric Nephrology
- Transplant Surgery
- Long-term Patient Outcomes
Background:
- Kidney transplantation is the optimal treatment for pediatric end-stage renal disease, significantly improving quality of life.
- Longitudinal studies tracking adult outcomes of childhood kidney transplants are scarce, limiting understanding of long-term achievements and challenges.
Purpose of the Study:
- To evaluate the long-term outcomes of adult survivors of pediatric kidney transplantation.
- To assess graft and patient survival rates, and analyze the quality of life, educational attainment, and social integration of these individuals.
Main Methods:
- Retrospective analysis of 287 patients undergoing 345 kidney transplants between 1979 and 2019.
- Evaluation of graft and recipient survival, retransplantation rates, and long-term quality of life indicators.
Main Results:
- Significant improvements in patient and graft survival observed in the period 1997-2019 compared to 1979-1996.
- First living donor grafts demonstrated high 5- and 10-year survival rates (94% and 89%).
- Among adult survivors, 32% have partners and 6.6% have children, but educational levels are lower, and comorbidities are common.
Conclusions:
- Pediatric kidney transplant recipients experience enhanced life expectancy and graft survival, particularly with living donors.
- While generally satisfied, adult transplant survivors report unmet needs in social support and educational opportunities.
- Addressing these gaps is crucial for improving the overall quality of life for individuals who received kidney transplants in childhood.
Introduction And Objectives:
There is currently no doubt that a kidney transplant with good function is the best treatment we can offer a child with severe kidney failure, improving their growth, development and life in general. But there are few works that follow these patients over the years to find out what their life is like as adults, their achievements and if there are any difficulties that may have arisen from their illness. That has been the objective of this work.
Material And Methods:
We have collected the evolution of 287 patients who received at least one kidney transplant in pediatric age, analyzing not only the survival of grafts and recipients but, fundamentally, their current quality of life.
Results:
Over a 40-year period (1979-2019), 345 kidney transplants were performed in 287 pediatric recipients, with a rate of retransplantation before reaching the age of majority of 16.7%. Survival, both of patients and grafts, has improved remarkably in the last 20 years. The survival of transplanted patients in the period from 1979 to 1996 at 10, 20 and 25 years after the intervention was 83%, 76% and 65% respectively, and 94% and 82% at 10 and 20 years respectively in those transplanted in the period from 1997 to 2019. Graft survival in the period from 1979 to 1996 at 10 and 20 years was 39% and 18%, increasing in the second period to 68% and 34% respectively. Survival of the first living donor graft (LD) at 5 and 10 years was 94% and 89%. Currently 150 of these patients are adults. Of these, 32% have a stable partner and 6.6% have children. The level of training is lower than that of the general population and many of them have other comorbidities.
Conclusions:
The life expectancy of pediatric patients with kidney failure transplanted during childhood has improved markedly in recent decades, as has graft survival, being better with a living donor. In general, they consider themselves satisfied with their lives, with great acceptance of their illness and limitations, but -analyzing their testimonies- we conclude that they lack social support, both for themselves and their families, to achieve a higher level of education and better quality of life.
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