The influence of low donor age, living related donation and pre-emptive transplantation on end-organ damage based on arterial hypertension after paediatric kidney transplantation.

Background. To date, no study has described the pre-transplant and transplant risk factors for end-organ damage based on arterial hypertension in children after kidney transplantation (KTX).Methods. A retrospective chart review was performed of 206 children with KTX between 1991 and 2007. Patients <120 cm were excluded as no validated percentiles for 24-h ambulant blood pressure monitoring (ABPM) exist. Complete data sets were available for 116 patients. Data were recorded at 12, 24 and 36 months post- KTX. We analysed the influence of donor age, age at transplantation, pre-emptive transplantation, living or deceased transplantation and glomerular filtration rate (GFR) on the presence of end-organ damage, ABPM, ABPM standard deviation score and the numbers of anti-hypertensives used.Results. Lower donor age and the decade of transplantation were associated with less detection of end-organ damage (P = 0.001). A lower need for anti-hypertensive medication (P = 0.001) was detected in children who received organs from living donors and from deceased donors with a donor age <35 years and who were transplanted pre-emptively. Low recipient age was the only factor associated with lower ABPM (P = 0.001). In our study, the type of immunosuppressive regimen and the GFR had no influence on the blood pressure.Conclusions. It may be speculated that the risk of arterial hypertension and associated end-organ damage in children after KTX could be reduced by using organs from young donors with an advantage for living related and pre-emptive donation. [ABSTRACT FROM PUBLISHER]