小儿肾移植后的住院治疗：加拿大儿科移植中心、北美儿科肾脏试验和协作研究与合作的欧洲儿科肾脏移植倡议登记处数据的国际比较。

Hospitalization following pediatric kidney transplantation: An international comparison among a Canadian pediatric transplant center, North American Pediatric Renal Trials and Collaborative Studies, and Cooperative European Pediatric Renal Transplant Initiative registry data.

机构信息

Division of Urology, Department of Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.

Department of Surgery, University of Toronto, Toronto, Ontario, Canada.

出版信息

Pediatr Transplant. 2022 Aug;26(5):e14273. doi: 10.1111/petr.14273. Epub 2022 Mar 27.

DOI:10.1111/petr.14273

PMID:35340109

Abstract

BACKGROUND

There are several databases across the world that collect pediatric KT data. We compare the hospitalization outcomes for pediatric KT recipients from a large Canadian transplant center (SickKids database; The Hospital for Sick Children Kidney Transplantation Institutional Database), United States (NAPRTCS), and Europe (CERTAIN registry).

METHODS

An institutional retrospective review of KT was performed between 2000 and 2015. Baseline characteristics, duration of initial hospitalization/readmission at 1-5 and 6- to 11-month posttransplant, and 1-year graft survival data were collected. Corresponding data from the NAPRTCS 2014 Annual Transplant Report and CERTAIN registry were compared.

RESULTS

Posttransplant, patients from NAPRTCS had the shortest duration of hospitalization within the first month (10.4 days, SE 0.2), followed by SickKids (20.3 days, SE 0.7) and CERTAIN (25.5 days, SE 0.7). For both living and deceased donor populations, patients from SickKids were most likely to be hospitalized at 1- to 5-month posttransplant (82.4% [89/108]; 72.1% [98/136]), followed by Europe (52.1% [198/380]; 61.6% [501/813]) and United States (45.4% [2379/5241]; 51.4% [2517/4896]). Patients from Europe were most likely to be hospitalized at 6- to 12-month posttransplant (42.1% [160/380]; 51.7% [420/813]), followed by SickKids (35.2% [38/108]; 37.5% [51/136]) and United States (28.3% [1387/4901]; 31.6% [1411/4465]). Across all databases, the most commonly addressed issues during readmissions were infectious complications.

CONCLUSION

The differences observed in this investigation may reflect the local reimbursement models, resources for outpatient management, and practice variations across a large Canadian transplant center, United States, and European countries.

摘要

背景

全球有多个数据库收集儿科肾移植数据。我们比较了来自加拿大一家大型移植中心（ SickKids 数据库； SickKids 肾脏移植机构数据库）、美国（NAPRTCS）和欧洲（CERTAIN 登记处）的儿科肾移植受者的住院结局。

方法

对 2000 年至 2015 年期间的肾移植进行机构回顾性分析。收集基线特征、初始住院时间/1-5 个月和 6-11 个月后再入院、移植后 1 年移植物存活率数据。比较 NAPRTCS 2014 年年度移植报告和 CERTAIN 登记处的相应数据。

结果

肾移植后，NAPRTCS 的患者在第一个月的住院时间最短（10.4 天，SE 0.2），其次是 SickKids（20.3 天，SE 0.7）和 CERTAIN（25.5 天，SE 0.7）。对于活体和已故供体人群，SickKids 的患者最有可能在 1-5 个月时住院（82.4%[89/108]；72.1%[98/136]），其次是欧洲（52.1%[198/380]；61.6%[501/813]）和美国（45.4%[2379/5241]；51.4%[2517/4896]）。欧洲的患者最有可能在 6-12 个月时住院（42.1%[160/380]；51.7%[420/813]），其次是 SickKids（35.2%[38/108]；37.5%[51/136]）和美国（28.3%[1387/4901]；31.6%[1411/4465]）。在所有数据库中，再入院时最常见的问题是感染并发症。