Pediatric Organ Transplants Pose High Risk of Advanced Kidney Disease

According to a new national study, children who undergo solid organ transplants are put at high risk of developing advanced kidney disease.

Those receiving lung or intestinal transplant face the highest risk, according to the study published in the journal Pediatrics.

The report, which included 16,600 participants, is the first to compare the rate of end-stage kidney disease (ESKD) based on the type of organ transplant in children, as well as the first to examine the risk of advanced kidney disease among pediatric solid organ recipients over the course of 20 years.

Three percent of those included in the study experienced ESKD, the researchers found, depending on the organ transplant, with individuals receiving liver transplants as children exhibiting the lowest risk.

In comparison, adult liver transplant recipients have the highest risk of ESKD, and adult lung transplant recipients less so. The risk of ESKD was similar for both children and adults, however, in the case of intestinal transplantation.

"We found that the risk patterns for kidney disease are different among patients who receive solid-organ transplants as children, compared to adult transplant recipients," pediatric nephrologist Dr. Rebecca Ruebner of The Children's Hospital said in a statement. "Because chronic and end-stage kidney disease carry high burdens of mortality and serious illness, it is important to take preventive measures to slow or prevent disease progression."

The study, according to the researchers, reinforces the importance of ongoing screening of kidney function in young transplant recipients.

"Although the overall incidence of end-stage kidney disease was only 3 percent, the broader burden of chronic kidney disease is much higher in this population of pediatric transplant recipients," Ruebner said. "Children with chronic kidney disease experience a steady decline in kidney function, so we recommend that pediatric healthcare providers carefully follow post-transplant patients to detect any early signs of kidney problems, with early referral, if necessary, to a pediatric nephrologist."