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Background: The optimal age of kidney transplantation for infants and toddlers with kidney failure is unclear. We aimed to evaluate the patient survival associated with kidney transplantation before 2 years of age versus remaining on the waitlist until ≥2 years. Method: We used the Scientific Registry of Transplant Recipients to identify all children added to the deceased‐donor waitlist before 2 years of age between 1/1/2000 and 4/30/2020. For each case aged <2 years at transplant, we created a control group comprising all candidates on the waitlist on the case's transplant date. Patient survival was evaluated using sequential Cox regression. Dialysis‐free time was defined as graft survival time for cases and the sum of dialysis‐free time on the waitlist and graft survival time for controls. Results: We observed similar patient survival for posttransplant periods 0–3 and 4–12 months but higher survival for period >12 months for <2‐year decreased‐donor recipients (aHR: 0.32; 95% CI: 0.13–0.78; p =.01) compared with controls. Similarly, patient survival was higher for <2‐year living‐donor recipients for posttransplant period >12 months (aHR: 0.21; 95% CI: 0.06–0.73; p =.01). The 5‐year dialysis‐free survival was higher for <2‐year deceased‐ (difference: 0.59 years; 95% CI: 0.23–0.93) and living‐donor (difference: 1.84 years; 95% CI: 1.31–2.25) recipients. Conclusion: Kidney transplantation in children <2 years of age is associated with improved patient survival and reduced dialysis exposure compared with remaining on the waitlist until ≥2 years. [ABSTRACT FROM AUTHOR]

Kidney transplantation entails well‐coordinated complex care delivery. Patient‐provider cultural and linguistic discordance can lead to healthcare disparities. We analyzed kidney transplantation outcomes among our institution's Hmong recipients using a retrospective cohort study. From 1995 to 2015, 2164 adult (age ≥18) recipients underwent kidney transplantation at our institution; 78 self‐identified as Hmong. Survival rates were analyzed and compared to Caucasian recipients (n = 2086). Fifty (64.1%) Hmong recipients consistently requested interpreters. Mean follow‐up was 9.8 years for both groups. Hmong recipients (N = 78) were on average younger at transplant (45.7 vs 49.7 years; P = 0.02), more likely to be female (56% vs 38%; P = 0.001), and had higher gravidity (5.0 vs 1.9 births; P < 0.001). There were 13 (16.7%) Hmong living donor recipients, who were younger (32.8 vs 42.9 years; P = 0.006) at transplant compared to Caucasians (1429, 68.5%). Hmong 1‐ and 5‐year patient survival was 100%; Caucasians, 97.1% and 88% (P < 0.001). Hmong 1‐ and 5‐year graft survival was 98.7% and 84.9%; Caucasians 94.8% and 80.9% (P = 0.013). One‐ and 5‐year rejection‐free survival showed no difference (88.9% vs 82.4%; 86.7% vs 83.4%, P = 0.996). Despite cultural and linguistic differences between Hmong recipients and providers, we found no evidence of inferiority in KT outcomes in the Hmong population. [ABSTRACT FROM AUTHOR]