POS-787 LONG-TERM OUTCOMES OF KIDNEY TRANSPLANTATION IN CHILDREN WITH CAKUT VERSUS NON-CAKUT CAUSES OF CHRONIC KIDNEY DISEASE

Abstract

Congenital anomalies of the kidney and urinary tract (CAKUT) are the most common cause of end stage renal disease in children. Little is known about long-term outcomes after kidney transplantation in this group. The aim of this study is to evaluate the clinical characteristics of pediatric kidney transplantation (KTx) in CAKUT children and its outcomes. We conducted a retrospective study, from December 2007 to December 2020, including living donor kidney transplant recipients ≤17 years transplanted in our center. Patients were divided into those with CAKUT and those with non-CAKUT as the cause of chronic kidney disease (CKD). Our aim was to compare delayed graft function (DGF) rate, acute rejection, complication’s rates, and graft loss between groups. A total of 259 living donor kidney transplants were done till 2019. 38 (15%) were ≤17 years, The cause of CKD was CAKUT in 13 patients (34,2%) and non-CAKUT in 25 patients. Of the latter, 15 (60%) had glomerular disease. The most common CAKUT-related cause of CKD was primary vesicoureteral reflux (84,6%). There was no difference in age between the groups, with a mean age of 13,4 +/- 2,9 years in the CAKUT group and 12,7 +/- 3,4 years in the non-CAKUT group (p=0,542). Recipients with CAKUT showed female preponderance, and were more likely to be seropositive for both CMV and EBV (all p<0,05). A nephrectomy is most often performed in patients with CAKUT (53,8%) versus 4,3% in the non CAKUT patients (p=0,001). For both groups, there was no difference in cytotoxic PRA (15,4 % vs 16%, p=0,331) or mean number of compatibilities (3,53 vs 2,92, p=0,314). The post transplant hypertension was significantly higher in non CAKUT recipients than in those with CAKUT (p=0,049). . Compared to non CAKUT-group, CAKUT patients had more urinary tract infection (p=0,043). There was no difference in DGF (7,7% vs 8%, p=0,734), Acute rejection (7,7% vs 20%, p=0,141) or graft loss (7,7% vs 8%, p=0,784). Graft survival of the transplant in children with CAKUT is favourable. However, they have an increased risk of urinary tract infections.