Abstract
Demographic data and the outcomes of pediatric kidney transplantations in Japan were reviewed based on the Japanese Renal Transplant Registry data from the Japanese Society for Clinical Renal Transplantation and the Japanese Society for Transplantation. The children were defined as patients who had not yet attained their 20th birthday at the time of transplant. A total of 2,876 kidney transplantations have been performed on children in Japan from 1964 to 2014. Transplants were categorized into four time periods (1964-1985, 1986-1995, 1996-2001, and 2002-2014) to reflect changes in immunosuppression practices over time (in general, introduction of cyclosporine, tacrolimus, mycophenolate mofetil, and basiliximab). Patient demographics have changed over time with an increase in the percentage of younger recipients, preemptive kidney transplantations and ABO-incompatible kidney transplantations. Patient survival and graft survival have also improved tremendously. The 5- and 10-year Kaplan-Meier estimates of patient/graft survival in living-donor recipients were 98.9/96.4% and 98.1/92.3% in the 2002-2014 cohorts. Also, the 5- and 10-year Kaplan-Meier estimates of patient/graft survival in deceased-donor recipients were 98.1/83.5% and 96.6/68.0% in the 2002-2014 cohorts. More efforts to define the clinical features and outcomes of pediatric kidney transplant patients are essential for better treatments for children with end-stage renal disease.
