Teen Kidney Patients More Likely to Suffer Transplant Failure
Teenage kidney transplant recipients may face higher risk of transplant failure, according to a new study.
New research suggests that patients who received their first kidney at ages 14 to 16 years are more likely to experience transplant failure, with black adolescents having a significantly higher risk of graft failure.
Researchers explain that organ losses by adolescents are partly caused by physiologic or immunologic changes with age. However, psychological and sociological factors may also play a role, especially when the affect medication adherence, according to the study.
Lead researcher Dr. Kenneth A. Andreoni, of the University of Florida, Gainesville, and his team analyzed 168,809 first kidney-only transplants from October 1987 through October 2010.
Researchers found that adolescent recipients aged 14 to 16 years had the highest risk of any age group of graft loss, starting at one year after transplants, and amplifying at three, five and 10 years after transplants.
"Black adolescents are at a disproportionate risk of graft failure at these time points compared with nonblack adolescents," researchers wrote in the study.
The study also found that donor type and insurance type also affected the risk of transplant failure.
"Among 14-year-old recipients, the risk of death was 175 percent greater in the deceased donor-government insurance group vs. the living donor-private insurance group (hazard ratio, 0.92 vs. 0.34), whereas patient survival rates in the living donor-government insurance and deceased donor-private insurance groups were nearly identical (hazard ratio, 0.61 vs. 0.54)," study authors wrote.
Researchers said the findings suggest that comprehensive programs are needed for adolescent transplant recipients.
"The realization that this age group is at an increased risk of graft loss as they are becoming young adults should prompt providers to give specialized care and attention to these adolescents in the transition from pediatric to adult-focused care. Implementing a structured health care transition preparation program from pediatric to adult-centered care in transplant centers may improve outcomes," researchers concluded.
The findings are published in the journal JAMA Internal Medicine.