Jelena Stojanovic, United Kingdom has been granted the CareDx Congress Scientific Awards
Dr Stojanovic is a consultant paediatric nephrologist with over 15 years of experience in renal transplantation. She is the lead for renal transplant service at Great Ormond Street Hospital for Children, UK's largetst paediatric renal transplant centre. Her areas of expertise include complex transplantations such as antibody incompatible kidney transplantation, multi soild organ transplantation and transplantation of children with metabolic conditions. Dr Stojanovic is a Deputy Co-Chair for the paediatric Kidney Advisory Group in the UK and an elected transplant tariff advisor for the NHS England Transplant Programme. She is the recipient of the Young Investigator Award by the Americal Society for Transplantation and regularly publishes in transplant journals. She is a Senior Lecturer at the Institute for Child Health at the University College London.
ABO incompatible LRD kidney transplantation should be offered to children before listing on DD waitlist: results from a 33-year comparative OPTN study
Alicia Paessler1, Ioannis Loukopoulos1,2, Pankaj Chandak1, Nicos Kessaris1,2, Jelena Stojanovic1,3.
1Renal Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom; 2Transplant Surgery, Guys and St Thomas' NHS Foundation Trust, London, United Kingdom; 3Institute of Child Health, UCL, London, United Kingdom
Introduction: ABOi transplantation from living donors is a growing practice with excellent clinical outcomes. Some paediatric transplant programmes are still reluctant to offer ABOi transplantation and list children on a DD waiting list. However, there are no studies directly comparing the outcomes between pediatric ABOi living donor kidney transplants (LDKTx) and ABOc deceased donor transplants (DDKTx).
Method: Data were retrieved on all pediatric kidney transplants from 1987-2020, from the United Network for Organ Sharing. Propensity score matching was used to select a control group of ABOc transplant recipients. Long term outcomes were compared between ABOi and ABOc kidney transplants and between ABOi LDKTx and ABOc transplants DDKTx. Data were compared using chi-square test, t-test and Kaplan-Meier survival analysis.
Results: Overall, there were 70 pediatric ABOi kidney transplants in the US during the study period. There was no significant difference in allograft (p=0.42) and patient survival (p=0.58), and no difference in rates of delayed allograft function or primary allograft non-function (p=0.89, p=0.77) between ABOi and ABOc transplants. ABOi LDKTx had significantly lower rates of delayed allograft function and better long-term allograft survival than ABOc DDKTx (p<0.01, p=0.01).
Conclusion: ABOi transplantation has excellent long-term outcomes. More importantly, ABOi LDKTx lead to better long-term outcomes than ABOc DDKTx. We recommend that ABOi transplantation from a living donor should be considered prior to listing children for transplantation from a deceased donor.
[1] ABOi
[2] Kidney Transplant
[3] OPTN