{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T19:06:56Z","timestamp":1783451216989,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T00:00:00Z","timestamp":1611878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>There are no guidelines regarding management of failed pediatric renal transplants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials &amp; Methods<\/jats:title><jats:p>We performed a first of its kind multicenter study assessing prevalence of transplant nephrectomy, patient characteristics, and outcomes in pediatric renal transplant recipients with graft failure from January 1, 2006, to December 31, 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fourteen centers contributed data on 186 pediatric recipients with failed transplants. The 76 recipients that underwent transplant nephrectomy were not significantly different from the 110 without nephrectomy in donor or recipient demographics. Fifty\u2010three percent of graft nephrectomies were within a year of transplant. Graft tenderness prompted transplant nephrectomy in 91% (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). Patients that underwent nephrectomy were more likely to have a prior diagnosis of rejection within 3\u00a0months (43% vs 29%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.04). Nephrectomy of allografts did not affect time to re\u2010listing, donor source at re\u2010transplant but significantly decreased time to (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.009) and incidence (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0002) of complete cessation of immunosuppression post\u2010graft failure. Following transplant nephrectomy, recipients were significantly more likely to have rejection after re\u2010transplant (18% vs 7%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03) and multiple rejections in first year after re\u2010transplant (7% vs 1%; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Practices pertaining to failed renal allografts are inconsistent\u201440% of failed pediatric renal allografts underwent nephrectomy. Graft tenderness frequently prompted transplant nephrectomy. There is no apparent benefit to graft nephrectomy related to sensitization; but timing \/ frequency of immunosuppression withdrawal is significantly different with slightly increased risk for rejection following re\u2010transplant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.13974","type":"journal-article","created":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T16:15:16Z","timestamp":1611936916000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Practice patterns and influence of allograft nephrectomy in pediatric kidney re\u2010transplantation: A pediatric nephrology research consortium study"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8836-0881","authenticated-orcid":false,"given":"Priya S.","family":"Verghese","sequence":"first","affiliation":[{"name":"Division of Pediatric Nephrology Department of Pediatrics Northwestern University Feinberg School of Medicine and Ann &amp; Robert H. Lurie Children's Hospital of Chicago Chicago IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kera E.","family":"Luckritz","sequence":"additional","affiliation":[{"name":"Department of Pediatrics C.S. Mott Children\u2019s Hospital Michigan Medicine Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9376-6659","authenticated-orcid":false,"given":"Asha","family":"Moudgil","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology Children National Hospital Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayanthi","family":"Chandar","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology Department of Pediatrics University of Miami Miller School of Medicine and Miami Transplant Institute Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Ranch","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pediatric Nephrology Joe R. and Teresa Lozano Long School of Medicine University of Texas Health at San Antonio San Antonio TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Barcia","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology Department of Pediatrics University of Virginia School of Medicine Charlottesville VA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jen\u2010Jar","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Nephrology Wake Forest University Baptist Health Winston\u2010Salem NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Grinsell","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension Department of Pediatrics University of Utah School of Medicine Salt Lake City UT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rima","family":"Zahr","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology Department of Pediatrics University of Tennessee Health Science Center Memphis TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Engen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology Department of Pediatrics Northwestern University Feinberg School of Medicine and Ann &amp; Robert H. 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samhar","family":"Al\u2010Akash","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology Department of Pediatrics Driscoll Children's Hospital Corpus Christi TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Bartosh","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology Department of Pediatrics University of Wisconsin School of Medicine and Public Health Madison WI 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