Evaluation of the implementation of a “Pediatric Feasibility Assessment for Transplantation” tool in children and adolescents at Red Cross War Memorial Children's Hospital, Cape Town, South Africa

Author:

Adetunji Adewale E.12ORCID,Gajjar Priya3ORCID,Luyckx Valerie A.145ORCID,Reddy Deveshni13ORCID,Collison Nicolette1,Abdo Theresa1,Pienaar Taryn1,Nourse Peter13,Coetzee Ashton13ORCID,Morrow Brenda13ORCID,McCulloch Mignon I.13ORCID

Affiliation:

1. Red Cross War Memorial Children's Hospital Cape Town South Africa

2. Irrua Specialist Teaching Hospital Irrua Nigeria

3. University of Cape Town Cape Town South Africa

4. Department of Public and Global Health, Epidemiology, Biostatistics and Prevention Institute University of Zurich Zurich Switzerland

5. Renal Division, Brigham and Women's Hospital Harvard Medical School Boston Massachusetts USA

Abstract

AbstractBackgroundKidney transplantation remains the treatment of choice for children with kidney failure (KF). In South Africa, kidney replacement therapy (KRT) is restricted to children eligible for transplantation. This study reports on the implementation of the Paediatric Feasibility Assessment for Transplantation (pFAT) tool, a psychosocial risk score developed in South Africa to support transparent transplant eligibility assessment in a low‐resource setting.MethodsSingle‐center retrospective descriptive analysis of children assessed for KRT using pFAT tool from 2015 to 2021.ResultsUsing the pFAT form, 88 children (median [range] age 12.0 [1.1 to 19.0] years) were assessed for KRT. Thirty (34.1%) children were not listed for KRT, scoring poorly in all domains, and were referred for supportive palliative care. Fourteen of these 30 children (46.7%) died, with a median survival of 6 months without dialysis. Nine children were reassessed and two were subsequently listed. Residing >300 km from the hospital (p = .009) and having adherence concerns (p = .003) were independently associated with nonlisting. Of the 58 (65.9%) children listed for KRT, 40 (69.0%) were transplanted. One‐year patient and graft survival were 97.2% and 88.6%, respectively. Only one of the four grafts lost at 1‐year posttransplant was attributed to psychosocial issues.ConclusionsShort‐term outcomes among children listed using the pFAT form are good. Among those nonlisted, the pFAT highlights specific psychosocial/socioeconomic barriers, over which most children themselves have no power to change, which should be systemically addressed to permit eligibility of more children and save lives.

Publisher

Wiley

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Basic Ethical Principles for the Pediatric Nephrologist;Current Pediatrics Reports;2024-07-30

2. Discontinuation of maintenance peritoneal dialysis in children—A 10-year review from a single center in a low resource setting;Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis;2024-06-11

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