Pediatric kidney transplantation profile in Ukraine (2001-2025)

Abstract

The increasing prevalence of CKD and kidney replacement therapy has contributed to the progress of kidney transplantation worldwide. The present study aimed to evaluate the current status and outcomes of kidney transplantation in a national pediatric cohort and to determine the impact of selected epidemiological factors on graft survival.

Methods. The analysis of 373 primary kidney transplantation episodes was conducted in recipients under the age of 18. The observational study had a retrospective design with in-depth data from 2001 and was held for statistical and scientific purposes using depersonalized data.

Results. The cumulative 5-year graft survival in children in Ukraine was close to the average ESPN/ERA Registry data and ranged from 80.1% to 87.7% depends of the analysis period. The cohort was shown to have similar basic characteristics to the international one based on CKD etiology (kidney structure anomalies dominance), waiting list time (10.5-12.0 months) and the median age of intervention (12.6-12.9 years). Negative etiology and age zones have been identified: the higher graft failure risk in the first 12 months in patients with CAKUT, polycystic kidney disease, after-AKI-state and in youngest age (≤3 years); continued high risk in the next period (from 12 months to 5 years) in polycystic kidney disease and AKI, significant increased risk in patients with history of glomerulonephritis, and risk in adolescence (>10 years).

Conclusion. The increase in pediatric transplantation rate in Ukraine, with the recipient’s age rejuvenation and post-mortem donation accretion, has accentuated the challenges of patient management. The identified clinical groups at increased risk of graft loss for different observation periods (up to 12 months and after 12 months until 5 years) require additional attention to detect the reasons for unfavorable outcomes and to provide long-term graft function.