Long-Term Patient and Graft Survival for Children and Young Adults after Kidney Transplantation and Re-Transplantation - Results from the ERA Registry
Abstract
Long-term outcomes after kidney re-transplantation in patients with childhood-onset kidney replacement therapy (KRT) are poorly characterized. Using European Renal Association Registry data, we studied 12,623 patients who started KRT before age 20 years and received one (n = 11,078), two (n = 2,962) or three (n = 718) kidney transplants (KTs) between 1978 and 2019. In this descriptive study, 5-, 10- and 15-year patient survival was 97, 94 and 90 % after first, 97, 95, 94 % after second and 96, 94, 92 % after third KT; corresponding graft survival was 79, 63, 50 %, 69, 52, 38 %, and 67, 51, 38 %, respectively. After first KT, mortality and graft failure risks were lower after pre-emptive transplantation (adjusted hazard ratio: 0.66 [95% CI 0.54-0.80] and 0.89 [0.82-0.97], respectively) and after living donor (LD) transplantation (0.71 [0.61-0.83] and 0.76 [0.70-0.81], respectively). Additionally, graft failure risk was higher between ages 10-24 years, and for patients with glomerulonephritis, metabolic diseases or recurrent nephropathies, and females. In re-transplants, LD and pre-emptive KTs (particularly for second KT) and prior graft survival > 5 years were associated with reduced graft failure. Overall, LD, pre-emptive transplantation, and durable prior grafts were associated with the best outcomes.
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BibTeX
@article{stojanovic2026longterm,
title = {{Long-Term Patient and Graft Survival for Children and Young Adults after Kidney Transplantation and Re-Transplantation - Results from the ERA Registry}},
author = {Jelena Stojanovic and Søren S. Sørensen and Ann Christin Gjerstad and María Herrero-Goñi and Olga Lucía Rodriguez Arévalo and Michel Tsimaratos and Viktorija Kuzema and Mårten Segelmark and Runolfur Palsson and Alberto Ortiz and Kitty J. Jager and Jérôme Harambat and Evgenia Preka and Marjolein Bonthuis and Stephen D. Marks and Anneke Kramer and Vianda S. Stel and Lukas Buchwinkler and Belén Ponte and Anders Åsberg and Stella Stabouli},
journal = {American Journal of Transplantation},
year = {2026},
month = nov,
doi = {10.1016/j.ajt.2026.10.017},
url = {https://hal.science/hal-05858055v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Long-Term Patient and Graft Survival for Children and Young Adults after Kidney Transplantation and Re-Transplantation - Results from the ERA Registry
AU - Jelena Stojanovic
AU - Søren S. Sørensen
AU - Ann Christin Gjerstad
AU - María Herrero-Goñi
AU - Olga Lucía Rodriguez Arévalo
AU - Michel Tsimaratos
AU - Viktorija Kuzema
AU - Mårten Segelmark
AU - Runolfur Palsson
AU - Alberto Ortiz
AU - Kitty J. Jager
AU - Jérôme Harambat
AU - Evgenia Preka
AU - Marjolein Bonthuis
AU - Stephen D. Marks
AU - Anneke Kramer
AU - Vianda S. Stel
AU - Lukas Buchwinkler
AU - Belén Ponte
AU - Anders Åsberg
AU - Stella Stabouli
PY - 2026
DA - 2026/11/09
JO - American Journal of Transplantation
DO - 10.1016/j.ajt.2026.10.017
UR - https://hal.science/hal-05858055v1
AB - Long-term outcomes after kidney re-transplantation in patients with childhood-onset kidney replacement therapy (KRT) are poorly characterized. Using European Renal Association Registry data, we studied 12,623 patients who started KRT before age 20 years and received one (n = 11,078), two (n = 2,962) or three (n = 718) kidney transplants (KTs) between 1978 and 2019. In this descriptive study, 5-, 10- and 15-year patient survival was 97, 94 and 90 % after first, 97, 95, 94 % after second and 96, 94, 92 % after third KT; corresponding graft survival was 79, 63, 50 %, 69, 52, 38 %, and 67, 51, 38 %, respectively. After first KT, mortality and graft failure risks were lower after pre-emptive transplantation (adjusted hazard ratio: 0.66 [95% CI 0.54-0.80] and 0.89 [0.82-0.97], respectively) and after living donor (LD) transplantation (0.71 [0.61-0.83] and 0.76 [0.70-0.81], respectively). Additionally, graft failure risk was higher between ages 10-24 years, and for patients with glomerulonephritis, metabolic diseases or recurrent nephropathies, and females. In re-transplants, LD and pre-emptive KTs (particularly for second KT) and prior graft survival > 5 years were associated with reduced graft failure. Overall, LD, pre-emptive transplantation, and durable prior grafts were associated with the best outcomes.
SN - 1600-6135
SN - 1600-6143
ER -