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An analysis of information from Australia indicates that survival after kidney transplantation during childhood has improved drastically over the last 40 years, led by decreases in deaths from cardiovascular disease and infection. The findings appear in an upcoming issue of CJASN.

Survival rates have improved in recent years for children who have received kidney transplants, but it's unclear whether causes of death have changed over time. To investigate, Anna Francis, Ph.D. (University of Sydney, in Australia) and her colleagues analyzed information on all recipients of a first who were aged 19 years or under in Australia and New Zealand between 1970 and 2015.

A total of 1810 recipients were followed for a median of 13.4 years. Of these, 431 (24%) died, 174 (40%) from cardiovascular causes, 74 (17%) from infection, 50 (12%) from cancer, and 133 (31%) from other causes.

Survival rates improved over time, with 5-year survival rising from 85% for those first transplanted in 1970-1985 to 99% in 2005 to 2015. This was primarily due to reductions in deaths from cardiovascular causes and infections. Compared with patients transplanted in 1970-1985, mortality risk was 72% lower among those transplanted in 2005-2015, after adjusting for potential confounding factors.

"We were hoping to see if survival had improved over time and are delighted to see the massive improvements for children with kidney transplants," said Dr. Francis.

More information: "Survival after Kidney Transplantation During Childhood and Adolescence," CJASN, DOI: 10.2215/CJN.07070619