{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:23:31Z","timestamp":1788276211699,"version":"build-2803163510"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"crossref","award":["Current Research Annual Funding"],"award-info":[{"award-number":["Current Research Annual Funding"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Among 72 patients with childhood-onset ANCA-associated vasculitis, kidney transplant survival was good (86%).<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>ANCA-associated vasculitis relapse occurred in 8 patients (11%), a median of 71 months after transplantation and resulted in graft failure in only one case.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Positive ANCA at the time of transplantation did not predict graft failure but was associated with a higher risk of relapse and worse graft function.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>ANCA-associated vasculitis (AAV) is rare in children, and results in kidney failure in up to one third of cases. There is very limited knowledge on kidney transplantation in childhood-onset AAV. We assessed kidney transplantation outcomes and prognostic factors in a multicenter cohort of patients with childhood-onset AAV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients diagnosed with AAV during childhood (\u226418 years) who received a kidney transplant were included in this retrospective study. We determined patient and graft survival, rates of chronic graft dysfunction (defined as eGFR &lt;60 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      for \u22653 months) and AAV relapse, and assessed determinants of outcome with logistic regression models. Patients were matched 1:2 for age, sex, and era of transplantation with non-AAV recipients from the Hospital for Sick Children in Toronto, Canada, and their graft survival was compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 72 patients, of whom 53 (74%) had microscopic polyangiitis and 19 (26%) granulomatosis with polyangiitis. Their median age (interquartile range at the time of diagnosis and transplantation was 12 (9\u201314) and 14 (12\u201316) years, respectively. After a median post-transplant follow-up of 53 months (interquartile range, 25\u201397), 70 patients (97%) were alive, 62 (86%) had a functioning graft, 28 (39%) had developed chronic graft dysfunction, and 8 (11%) had experienced AAV relapse. Graft survival was comparable between AAV and non-AAV recipients. Acute rejection was the only independent predictor of graft failure (hazard ratio [HR], 12.11; 95% confidence interval [CI], 1.19 to 122.49). Positive ANCA at the time of transplantation was significantly associated with a chronic graft dysfunction (HR, 4.16; 95% CI, 1.71 to 10.13) and AAV relapse (HR, 23.1; 95% CI, 2.67 to 200.28).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with childhood-onset AAV show good overall and graft survival after kidney transplantation and a low rate of post-transplant relapse. Further studies are warranted to confirm whether positive ANCA at the time of transplantation is associated with poorer graft outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.0000000936","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T17:01:37Z","timestamp":1767891697000},"page":"480-493","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Kidney Transplantation in Childhood-Onset ANCA-Associated Vasculitis"],"prefix":"10.2215","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1578-4402","authenticated-orcid":false,"given":"Giorgio","family":"Trivioli","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Cambridge, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9949-3543","authenticated-orcid":false,"given":"Marco","family":"Allinovi","sequence":"additional","affiliation":[{"name":"Nephrology and Transplantation Unit, Careggi University Hospital, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elio","family":"Di Marcantonio","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Nuovo San Giovanni di Dio Hospital, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7600-7178","authenticated-orcid":false,"given":"Natasha A.","family":"Jawa","sequence":"additional","affiliation":[{"name":"School of Medicine, Queen's University, Kingston, Ontario, Canada"},{"name":"Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3538-5751","authenticated-orcid":false,"given":"Antonella","family":"Trivelli","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Dialysis and Transplantation, Scientific Institute for Research and Health Care Giannina Gaslini, Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology, Tongji Hospital, Wuhan, China"},{"name":"Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6814-6589","authenticated-orcid":false,"given":"Ryszard","family":"Grenda","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Kidney Transplantation and Hypertension, Children's Memorial Health Institute, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Rubik","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Kidney Transplantation and Hypertension, Children's Memorial Health Institute, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7169-6936","authenticated-orcid":false,"given":"Aladdin J.","family":"Mohammad","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Cambridge, Cambridge, United Kingdom"},{"name":"Section of Rheumatology, Department of Clinical Sciences, Lund University, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3062-8985","authenticated-orcid":false,"given":"Sara","family":"Testa","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Paediatric Nephrology, Dialysis and Transplantation, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1815-7327","authenticated-orcid":false,"given":"Timo","family":"Jahnukainen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology and Transplantation, Children's Hospital, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bora","family":"Gulhan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology, Hacettepe University, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6423-0927","authenticated-orcid":false,"given":"Rezan","family":"Topaloglu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology, Hacettepe University, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3573-9203","authenticated-orcid":false,"given":"Xavier","family":"Pu\u00e9chal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, H\u00f4pital Cochin, Assistance Publique-H\u00f4pitaux de Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1013-2253","authenticated-orcid":false,"given":"Joanna","family":"Kosa\u0142ka-W\u0119giel","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, Jagiellonian University Medical College, Krakow, Poland"},{"name":"Department of Rheumatology, Immunology and Internal Medicine, Krakow University Hospital, Krakow, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0191-4344","authenticated-orcid":false,"given":"Ismail","family":"Dursun","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology, Faculty of Medicine, Erciyes University, Kayseri, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4960-3083","authenticated-orcid":false,"given":"Isabella","family":"Guzzo","sequence":"additional","affiliation":[{"name":"Nephrology Unit, Bambino Ges\u00f9 Children's Research Hospital, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Pasini","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Unit, Policlinico Sant'Orsola Malpighi, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1180-8086","authenticated-orcid":false,"given":"Mikhail M.","family":"Kostik","sequence":"additional","affiliation":[{"name":"Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1532-2390","authenticated-orcid":false,"given":"Louise","family":"Oni","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health, University of Liverpool, Liverpool, United Kingdom"},{"name":"Department of Renal Medicine, UCL Centre for Kidney and Bladder Health, University College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Buti","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Florence, 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Biomedical Sciences, Humanitas Research Hospital, Humanitas University, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2883-7868","authenticated-orcid":false,"given":"Seza","family":"Ozen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Laurent","sequence":"additional","affiliation":[{"name":"H\u00f4pital Femme-M\u00e8re-Enfant, Hospices civils de Lyon, Service de N\u00e9phrologie, Rhumatologie et Dermatologie p\u00e9diatriques, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Harambat","sequence":"additional","affiliation":[{"name":"Pediatric Nephrology Unit, Bordeaux University Hospital, Bordeaux, 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Clinical Sciences \u201cMario Serio\u201d, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9575-8321","authenticated-orcid":false,"given":"Giacomo","family":"Emmi","sequence":"additional","affiliation":[{"name":"Italy and Clinical Medicine and Rheumatology Unit, Department of Medical, Surgery and Health Sciences, Cattinara University Hospital, University of Trieste, Trieste, Italy"},{"name":"Monash University Department of Medicine, Centre for Inflammatory Diseases, Monash Medical Centre, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1774-8088","authenticated-orcid":false,"given":"Paola","family":"Romagnani","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Florence, Italy"},{"name":"Department of Biomedical, Experimental and Clinical Sciences \u201cMario Serio\u201d, University of Florence, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9808-4518","authenticated-orcid":false,"given":"Moin A.","family":"Saleem","sequence":"additional","affiliation":[{"name":"Children's Renal Unit, Bristol Children's Hospital, Bristol, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Ware","sequence":"additional","affiliation":[{"name":"Paediatric Nephrology Department, Evelina Children's Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2468-4131","authenticated-orcid":false,"given":"Jianhua","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Pediatric Nephrology, Tongji Hospital, Wuhan, China"},{"name":"Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 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