Predictive Factors of Renal Graft Failure in Tunisian Children and young adults: A Retrospective Study

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Published Feb 11, 2024
https://doi.org/10.62438/tunismed.v102i1.4328
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Vol. 102 No. 1 (2024): Tunis med jan 2024

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Abir Boussetta
Department of Pediatric nephrology, Charles Nicolle Hospital, Tunis, University of Tunis El Manar, Faculty of medicine of Tunis, Tunisia
https://orcid.org/0000-0002-8034-2355
Manel Jellouli
Department of Pediatric nephrology, Charles Nicolle Hospital, Tunis, University of Tunis El Manar, Faculty of medicine of Tunis, Tunisia
Tahar Gargah
Department of Pediatric nephrology, Charles Nicolle Hospital, Tunis, University of Tunis El Manar, Faculty of medicine of Tunis, Tunisia
Meriem Hajji
Department of Internal medicine A, Charles Nicolle Hospital, Tunis, University of Tunis El Manar, Faculty of medicine of Tunis, Tunisia
Hafedh Hedri
Department of Internal medicine A, Charles Nicolle Hospital, Tunis, University of Tunis El Manar, Faculty of medicine of Tunis, Tunisia
Ezzeddine Abderrahim
Department of Internal medicine A, Charles Nicolle Hospital, Tunis, University of Tunis El Manar, Faculty of medicine of Tunis, Tunisia

Abstract

Introduction: Pediatric end-stage renal disease is a rare but severe condition that causes numerous complications and impairs the quality of life of children. Kidney transplantation is the therapy of choice in pediatric end-stage renal disease.


Aim: Our study aimed to identify the predictive factors of renal graft failure after kidney transplantation in Tunisian children and young adults.


Methods: We conducted a retrospective bicentric study of children and young adults (age≤20 years) who had undergone renal transplantation between 1989 and 2019 in Tunisia. We analyzed long-term survival rates and complications after pediatric kidney transplantation and searched for predictive parameters for graft dysfunction. We used a univariate and a multivariate analysis to identify predictive factors of graft survival.


Results: A total of 112 patients underwent 115 kidney transplantations. Graft failure occurred in 30% of the cases. The overall 1-, 3-, 5- and 10-year graft survival rates were 92%, 89.1%, 85.9% and 74.5% respectively. The following parameters strongly influenced graft survival: immunosuppressive regimen including an association other than Mycophenolate mofetil- tacrolimus and corticosteroids (p=0.002), year of transplant (p<0.0001 for 1987–2000), deceased donor (p = 0.039), underlying etiology of end-stage renal disease (p=0.045), occurrence of acute or chronic rejection (p<0.001), a urine protein greater than 0.3 g/l per day (p=0.002), post-transplant urologic complications (p=0.002), five-year creatinine level>1.28 mg/dl (p<0.001). The overall 1-, 3-, 5- and 10-year patients survival rates were 97%, 95%, 90.2% and 84.4% respectively.


Conclusions: Our study identified several predictive factors of graft failure ..... ( abstract truncated at 250 words).

Keywords:

Kidney transplantation, children, predictive factors, living donors, deceased donors, graft survival, graft failure

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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