Living kidney donors for pediatric transplantation have quadrupled, with
many young patients receiving organs from parents or other relatives
OTTAWA, Feb. 28 /CNW Telbec/ - More young people in Canada diagnosed with
kidney failure are surviving, and one key explanation is an increase in the
use of kidney transplantation in young patients. This finding comes from the
Canadian Institute for Health Information's (CIHI) Treatment of End-Stage
Organ Failure in Canada, 1996 to 2005, (2007 Annual Report), a new report that
includes, for the first time, a special chapter focusing on pediatric
patients-those aged 19 and under-diagnosed with end-stage renal disease
While the number of young Canadians newly diagnosed with ESRD remained
fairly stable each year from 1981 to 2005 (low of 66, high of 103), survival
rates have improved considerably since 1981 primarily due to more kidney
transplantation in young patients. The number of young people living with ESRD
increased by 169% between 1981 and 2005 (550).
"A diagnosis of kidney failure in early life can have far-reaching,
life-long consequences," says Margaret Keresteci, Manager of Clinical
Registries at CIHI. "The good news is that children with kidney failure are
living longer, now that transplantation has become the treatment of choice for
The vast majority of young patients with kidney failure are living with a
kidney transplant, with the number increasing from just over 44% in 1981 to
77% in 2005. Conversely, over this period, the proportion of children treated
with dialysis decreased from 56% in 1981 to 22% in 2005. For those treated in
the decade between 1991 and 2000, five-year survival rates for young ESRD
patients living with a kidney transplant were considerably higher (96%) than
for those on dialysis (84%).
"We consider the increase in transplantation, and the corresponding
decline in dialysis treatment, a step in the right direction for the quality
of life for young kidney patients," says Dr. M. Clermont, pediatric
nephrologist at Montreal's St-Justine Hospital. "Kidney failure itself,
coupled with dialysis treatment, can be devastating to children with ESRD and
their families, in terms of physical development, quality and longevity of
Children more likely to be living with a kidney transplant than adult
end-stage renal disease patients
In 2005, the proportion of pediatric ESRD patients living with a
transplant (77%) was considerably higher than for those patients aged 20 and
over (39%). Young kidney failure patients were also much more likely to be
treated with a pre-emptive transplant (23%) than their adult counterparts
(3%). Pre-emptive transplants are those received by patients who never begin
treatment by dialysis.
Parents, siblings donate organs to young patients
The number of kidneys donated to young Canadians by a living donor
quadrupled over the 25-year study period and the majority of these organs
(90%) come from a parent (78%) or sibling (12%). "We know that young patients
with chronic kidney disease who receive a kidney transplant do better than
those on dialysis," says Keresteci. "There can be no better illustration of
what the 'gift of life' can mean than the positive changes we have seen in the
outcomes for young Canadians with ESRD. A transplant will mean a vastly
improved quality of life and a better chance for long-term survival."
Information on the number of children waiting for a transplant is
available only for the 10-year period from 1996 to 2005. During that time, the
number of patients waiting for kidney transplantation declined to 23 in 2005,
compared to 59 in 1996. This consistent reduction differs from the pattern
seen in adult ESRD patients, among whom the number waiting for transplants
increased from 2,331 in 1996 to 2,920 in 2005. There were no recorded deaths
of pediatric patients while waiting for a kidney transplant between 2004 and
Other report highlights
Additional highlights included in Treatment of End-Stage Organ Failure in
Canada, 1996 to 2005:
- The annual number of first-time liver transplants performed on
pediatric patients increased by 24% from 1996 to 2005.
- As of December 31, 2005, there were 713 people (of all ages) waiting
for a liver transplant in Canada.
- The number of liver transplants performed grew steadily over the
10 years for an overall increase of 241%.
- The number of children under the age of one year receiving donor
hearts fluctuated from year to year over the 25-year study period,
with the highest number recorded in 2005 (15).
- Between 1996 and 2005, 1,564 patients (of all ages) received a first-
time heart transplant and 58 required a subsequent transplant.
- Between 1996 and 2005, a total of 38 people under the age of 18
received a first-time lung transplant.
- The number of adult lung transplants increased by 91% between 1996 and
2005 (from 76 to 145).
- Between 1996 and 2005, there were 553 pancreas transplants recorded in
- The number of deceased organ donors (of all ages) in Canada changed
very little between 1996 (419) and 2005 (414).
- Between 1996 and 2005, there were 4,006 living donors (kidney and
liver living donors only). The number of living donors increased from
265 in 1996 to 502 in 2005.
The Canadian Institute for Health Information (CIHI) collects and analyzes
information on health and health care in Canada and makes it publicly
available. Canada's federal, provincial and territorial governments created
CIHI as a not-for-profit, independent organization dedicated to forging a
common approach to Canadian health information. CIHI's goal: to provide
timely, accurate and comparable information. CIHI's data and reports inform
health policies, support the effective delivery of health services and raise
awareness among Canadians of the factors that contribute to good health.
The report and the following figures and tables are available from CIHI's
website at www.cihi.ca.
Table 1 Number of New ESRD Patients, Birth to 19 Years, Canada, 1981
to 2005 (Table 66 in the report)
Figure 1 Unadjusted Three-Month and One-, Three- and Five-Year Patient
Survival for Pediatric Patients Treated With Dialysis and With
Transplantation, Canada, 1996 to 2005 (not in report)
Figure 2 Pediatric ESRD Patients Treated by Transplant, by Type of
Donor, Canada, 1981 to 2005 (not in report)
Table 2 Selected Donor Characteristics, Pediatric Kidney Transplants,
Canada, 1981 to 2005 (not in report)
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