The Prevalence and Consequences of Supra-Normal Estimated Glomerular Filtration Rate in Pediatric Solid Organ Transplants: A Single Center Cohort

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2026-05-01 Epub Date: 2026-04-12 DOI:10.1016/j.transproceed.2026.03.023

Melvin Chan , Scott R. Auerbach , Amy G. Feldman , Margret E. Bock

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引用次数: 0

Abstract

Purpose

In adult recipients of kidney transplants, renal hyperfiltration has been found to be associated with an earlier risk of graft loss. Unfortunately, data is sparse for pediatric recipients of solid organ transplants.

Methods

We reviewed all actively followed pediatric liver, heart, and kidney recipients at our center. We determined the estimated glomerular filtration rate (eGFR) during the first 5 years posttransplant and at the last follow-up based on the CKiD-U25 formula using creatinine. Given the lack of renal scintigraphy data, we used a supra-normal eGFR (SNeGFR) as a surrogate for hyperfiltration. SNeGFR was defined as two standard deviations above the mean eGFR for age, CKD as an eGFR of less than 90 mL/min/1.73m², and normal function between CKD and SNeGFR. A contingency table was used to determine the OR of outcomes for those with SNeGFR and normal function and normal function and CKD.

Results

A total of 443 actively followed patients were eligible. Forty-four (16%) of the recipients of heart and liver transplants met criteria for SNeGFR. Only one recipient of a kidney transplant met the criteria. In recipients of liver and heart transplants, SNeGFR was correlated with higher risks of developing hypertension than those with normal function (OR 2.22, CI 1.08-4.54). Recipients of liver and heart transplants with CKD not only had a similar risk (OR 2.22, CI 1.22-4.18) but also had a higher risk of having any rejections (OR 1.8, CI 1.06-3.09) than those with normal function.

Conclusions

SNeGFR is prevalent in recipients of liver and heart transplants. More studies need to evaluate its association with outcomes.

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儿童实体器官移植中肾小球滤过率估计超正常的患病率和后果：单中心队列研究。

目的：在成人肾移植受者中，肾脏超滤被发现与早期移植物丢失的风险相关。不幸的是，关于儿童实体器官移植接受者的数据很少。方法：我们回顾了本中心所有积极随访的儿童肝、心、肾受体。在移植后的前5年和最后一次随访中，我们根据ckidu25公式使用肌酐测定肾小球滤过率（eGFR）。鉴于缺乏肾显像数据，我们使用超正常eGFR （SNeGFR）作为超滤的替代指标。SNeGFR被定义为高于年龄平均eGFR两个标准差，CKD被定义为eGFR小于90 mL/min/1.73m2， CKD和SNeGFR之间的功能正常。使用列联表来确定SNeGFR和功能正常以及功能正常和CKD的结果的OR。结果：共有443名积极随访的患者符合条件。44例（16%）心脏和肝脏移植受者符合SNeGFR标准。只有一名肾移植受者符合标准。在肝和心脏移植受者中，SNeGFR与功能正常者发生高血压的风险相关（OR 2.22, CI 1.08-4.54）。患有CKD的肝脏和心脏移植受者不仅有相似的风险（OR 2.22, CI 1.22-4.18），而且与功能正常的受者相比，有更高的排斥反应风险（OR 1.8, CI 1.06-3.09）。结论：SNeGFR在肝、心移植受者中普遍存在。需要更多的研究来评估其与结果的关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.