Nephrol Dial Transplant (2003) 18: 2141-2146
© 2003 European Renal Association-European Dialysis and Transplant Association
Original Article
Kidney transplantation in children: impact of young recipient age on graft survival
1Abtelilung Nephrologie, Zentrum Innere Medizin und Dermatologie, 3Klinik für Abdominal- und Transplantationschirurgie, 4Zentrum für Kinderheilkunde and 5Medizinische Hochschule Hannover, Germany
Correspondence and offprint requests to: Professor Reinhard Brunkhorst, Klinik für Nieren-, Hochdruck- und Gefäßkrankheiten, Klinikum Hannover Oststadt, Podbielskistrasse 380, D-30659 Hannover, Germany. Email: sekretariat.brunkhorst.oststadt{at}klinikum-hannover.de
Background. It has been suggested that recipient age may have an effect on renal graft survival due to its potential influence on the competence of the immune system. A comparison of graft survival between children and elderly adults, however, has never been performed.
Methods. Forty patients 
18 years old were included in the study group and compared with a control group of patients 
65 years using a case–control analysis. Apart from age, matching criteria were the number of HLA mismatches and the date of transplantation.
Results. The mean age differed by 57 years between study and control group (10 ± 5 vs 67 ± 2, P < 0.001). There was no difference in the number of initially non-functioning grafts, sex distribution, immunosuppression, number of HLA mismatches on the HLA-DR, -B and -A locus, cold ischaemia time and the number of patients with panel-reactive antibodies. The only difference was a lower donor age in the study group (17 ± 14 vs 35 ± 16, P < 0.001) compared with the control group. During the follow-up of 109 ± 54 and 79 ± 49 months, respectively, acute rejections were more frequent in the study group (25 vs 12, P < 0.01). There was no significant difference in graft survival between both groups when death with functioning graft was excluded.
Conclusions. This study which compares two groups of patients with a mean age difference of 57 years could not demonstrate an effect of young recipient age on graft survival, though the incidence of acute rejections appeared to be significantly higher in the paediatric population. Thus paediatric renal transplanted patients do not seem to have a disadvantage regarding graft survival due to their young recipient age.
Keywords: acute rejection; cold ischaemia time; graft survival; HLA matching; kidney transplantation; recipient age
2Present address: Nephrologisches Zentrum Rendsburg-Eckernförde, Germany.
6Present address: Klinik für Nieren-, Hochdruck- und Gefäßkrankheiten, Klinikum Hannover Oststadt, Germany.
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