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Disparities in policies, practices and rates of pediatric kidney transplantation in Europe

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Abstract
We aimed to provide an overview of kidney allocation policies related to children and pediatric kidney transplantation (KTx) practices and rates in Europe, and to study factors associated with KTx rates. A survey was distributed among renal registry representatives in 38 European countries. Additional data were obtained from the ESPN/ERA- EDTA and ERA- EDTA registries. Thirty- two countries (84%) responded. The median incidence rate of pediatric KTx was 5.7 (range 0 - 13.5) per million children (pmc). A median proportion of 17% (interquartile range 2 - 29) of KTx was performed preemptively, while the median proportion of living donor KTx was 43% (interquartile range 10 - 52). The median percentage of children on renal replacement therapy (RRT) with a functioning graft was 62%. The level of pediatric prioritization was associated with a decreased waiting time for deceased donor KTx, an increased pediatric KTx rate, and a lower proportion of living donor KTx. The rates of pediatric KTx, distribution of donor source and time on waiting list vary considerably between European countries. The lack of harmonization in kidney allocation to children raises medical and ethical issues. Harmonization of pediatric allocation policies should be prioritized.
Keywords
SURVIVAL, DIALYSIS, ACCESS, Children, RENAL REPLACEMENT THERAPY, organ allocation, CHILDREN, health policy, WAITING-LIST, RACIAL DISPARITIES, DONOR KIDNEYS, DISEASE, kidney transplantation, ALLOCATION POLICY

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MLA
Harambat, J, KJ van Stralen, F Schaefer, et al. “Disparities in Policies, Practices and Rates of Pediatric Kidney Transplantation in Europe.” AMERICAN JOURNAL OF TRANSPLANTATION 13.8 (2013): 2066–2074. Print.
APA
Harambat, J, van Stralen, K., Schaefer, F., Grenda, R., Jankauskiene, A., Kostic, M., Macher, M.-A., et al. (2013). Disparities in policies, practices and rates of pediatric kidney transplantation in Europe. AMERICAN JOURNAL OF TRANSPLANTATION, 13(8), 2066–2074.
Chicago author-date
Harambat, J, KJ van Stralen, F Schaefer, R Grenda, A Jankauskiene, M Kostic, M-A Macher, et al. 2013. “Disparities in Policies, Practices and Rates of Pediatric Kidney Transplantation in Europe.” American Journal of Transplantation 13 (8): 2066–2074.
Chicago author-date (all authors)
Harambat, J, KJ van Stralen, F Schaefer, R Grenda, A Jankauskiene, M Kostic, M-A Macher, H Maxwell, Z Puretic, Ann Raes, J Rubik, SS Sørensen, Ü Toots, R Topaloglu, B Tönshoff, E Verrina, and KJ Jager. 2013. “Disparities in Policies, Practices and Rates of Pediatric Kidney Transplantation in Europe.” American Journal of Transplantation 13 (8): 2066–2074.
Vancouver
1.
Harambat J, van Stralen K, Schaefer F, Grenda R, Jankauskiene A, Kostic M, et al. Disparities in policies, practices and rates of pediatric kidney transplantation in Europe. AMERICAN JOURNAL OF TRANSPLANTATION. 2013;13(8):2066–74.
IEEE
[1]
J. Harambat et al., “Disparities in policies, practices and rates of pediatric kidney transplantation in Europe,” AMERICAN JOURNAL OF TRANSPLANTATION, vol. 13, no. 8, pp. 2066–2074, 2013.
@article{4252471,
  abstract     = {We aimed to provide an overview of kidney allocation policies related to children and pediatric kidney transplantation (KTx) practices and rates in Europe, and to study factors associated with KTx rates. A survey was distributed among renal registry representatives in 38 European countries. Additional data were obtained from the ESPN/ERA- EDTA and ERA- EDTA registries. Thirty- two countries (84%) responded. The median incidence rate of pediatric KTx was 5.7 (range 0 - 13.5) per million children (pmc). A median proportion of 17% (interquartile range 2 - 29) of KTx was performed preemptively, while the median proportion of living donor KTx was 43% (interquartile range 10 - 52). The median percentage of children on renal replacement therapy (RRT) with a functioning graft was 62%. The level of pediatric prioritization was associated with a decreased waiting time for deceased donor KTx, an increased pediatric KTx rate, and a lower proportion of living donor KTx. The rates of pediatric KTx, distribution of donor source and time on waiting list vary considerably between European countries. The lack of harmonization in kidney allocation to children raises medical and ethical issues. Harmonization of pediatric allocation policies should be prioritized.},
  author       = {Harambat, J and van Stralen, KJ and Schaefer, F and Grenda, R and Jankauskiene, A and Kostic, M and Macher, M-A and Maxwell, H and Puretic, Z and Raes, Ann and Rubik, J and Sørensen, SS and Toots, Ü and Topaloglu, R and Tönshoff, B and Verrina, E and Jager, KJ},
  issn         = {1600-6135},
  journal      = {AMERICAN JOURNAL OF TRANSPLANTATION},
  keywords     = {SURVIVAL,DIALYSIS,ACCESS,Children,RENAL REPLACEMENT THERAPY,organ allocation,CHILDREN,health policy,WAITING-LIST,RACIAL DISPARITIES,DONOR KIDNEYS,DISEASE,kidney transplantation,ALLOCATION POLICY},
  language     = {eng},
  number       = {8},
  pages        = {2066--2074},
  title        = {Disparities in policies, practices and rates of pediatric kidney transplantation in Europe},
  url          = {http://dx.doi.org/10.1111/ajt.12288},
  volume       = {13},
  year         = {2013},
}

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