672 Evaluation of Renal Function Following Pediatric Lung Transplantation

Abstract

Purpose: The goals of this study were to: 1. Determine the extent of decreased renal function following pediatric lung transplantation. 2. Characterize differences in primary diagnoses, co-morbidities and treatment that occur between children that undergo lung transplantation that develop decreased renal function from those who do not. Identify which characteristics are predictive of decreased renal function. 3. Identify which characteristics are predictive of decreased renal function. Methods and Materials: A data collection tool was used to extract data on 195 children receiving a primary lung transplant from January 1, 1990 to December 31, 2008. Of the sample, 107 patients were female and 90 patients had a primary diagnosis of cystic fibrosis (CF). Yearly data was obtained from the patient’s medical record and the Pediatric Lung Transplant Database. Repeated measures analysis of variance (ANOVA) was used to assess glomerular filtration rate over time. Survival analysis was used to compare death by patient characteristics. Cox proportional hazard regression analysis was used to assess the effect of patient characteristics on death. Results: The repeated measures ANOVA indicated a linear trend of GFR that was statistically significant over time for cystic fibrosis patients (p 0.00001). During the ten year post transplantation follow up, patients with CF died at a faster rate than those without CF (Log-Rank, p 0.02). Female patients died at a faster rate than male patients (Log-Rank, p 0.03). The final Cox model indicated that CF and gender increase the risk of death by 65% and 57% respectively. Conclusions: From this analysis, the lung transplant team will be able to provide more effective informed consent and pre-transplant education. Information will prompt changes in practice that will focus on improving renal function after transplant. Research should be implemented to determine why females die at a faster rate than males after transplant especially those with the diagnosis of CF. 673