Abstract: TH-PO815
Decreasing Trends in Pediatric Kidney Transplantation in Mexico, 2007-2023
Session Information
- Transplantation: Clinical - 2
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Oliva, Ana Elisa, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
- Raimann, Jochen G., Renal Research Institute, New York, New York, United States
- Mermelstein, Ariella E., Renal Research Institute, New York, New York, United States
- Nandorine Ban, Andrea, Renal Research Institute, New York, New York, United States
- Plascencia, Yuridia, Hospital de Pediatria Centro Medico Nacional de Occidente, Guadalajara, Jalisco, Mexico
- Medeiros, Mara, Hospital Infantil de Mexico Federico Gomez, Mexico City, Mexico City, Mexico
- Cisneros, Araceli, Hospital San Javier, Guadalajara, Jalisco, Mexico
- Chavez, Jonathan, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
- Garcia-Garcia, Guillermo, Universidad de Guadalajara Centro Universitario de Ciencias de la Salud, Guadalajara, Jalisco, Mexico
Background
Kidney transplantation (KT) is the most preferable therapy for children with end-stage kidney disease (ESKD). There is a paucity of information on temporal trends of KT in children in Mexico. We analyzed data of KT in children < 18 years between 2007-2023, to determine the presence of inequalities in access to KT.
Methods
In this retrospective study of pediatric ESKD patients receiving KT, we analyzed data from the national transplant center database between 2007- 2023. Transplant rates are presented by insurance status and donor type and standardized to the general population in the respective age segment as per million population (pmp). In the absence of a national dialysis registry, we estimated trends of dialysis prevalence based on data from the Jalisco state registry.
Results
We analyzed a total of 5,123 KT patients. The median age was 14 years (IQR 12 to 16), 57% males, and 71% were recipients from living donors. 32% were uninsured, 61% had public and 8% private insurance. Annual KT rates decreased steadily from 15.8 pmp in 2007 to 7.0 pmp in 2019, and further to 2.1 pmp during the COVID-19 pandemic, mainly in those with living donors (12.8 pmp to 3.5 pmp). The decrease was independent of health insurance status (Fig a to c). Consistently, in Jalisco KT rates dropped from 6.45 pmp in 2007 to 1.66 pmp in 2019 accompanied by a decrease in dialysis prevalence from 115.9 pmp in 2008 to 27.0 pmp in 2019 (Fig d).
Conclusion
Pediatric kidney transplant rates in Mexico have consistently decreased over the last 17 years, independent of health insurance status. Based on the results from Jalisco the drop is accompanied by a decrease in the number of dialysis patients. It remains to be evaluated if the decrease is caused by limited access to dialysis treatment or due to decreases in the prevalence of ESKD.
Pediatric kidney transplantation rates