For children and young people whose kidneys have failed, kidney transplantation offers the best chance of normal growth and development. Transplantation also places fewer limits on patients and is the most cost-effective treatment for kidney failure. We know from studies performed in the United States (US) and Europe that certain age groups (teenagers) can be at higher risk of losing kidney transplant function although the extent of this issue is not well described across childhood and young adulthood. We wish to investigate this for young kidney transplant recipients in the UK. We also want to understand how long kidneys last for in UK children and young adults and factors that impact on their survival.

The main aim of this project is to understand how long kidney transplants last in children and young adults aged <30 years (or 2-30 years at age of transplantation). We will do this by examining loss of kidney function (estimated glomerular filtration rate, eGFR) following transplant. We will also look at whether certain patient, transplant or kidney unit factors are linked to a greater fall in transplant function or loss. This will be the first study to look at changes in transplant function for all paediatric patients in the UK.

Single centre and national registry studies exist that describe kidney transplant survival and identify risk factors for graft loss. However, as these studies mainly originate from the US and mainland Europe, it is difficult to ascertain how findings can be applied and considered relevant to UK patients within the National Health Service (NHS). Further, studies from the UK are few, generally single-centre and therefore have limited generalisability to the wider UK population. Data from this project will offer patients, policy makers and stakeholders the opportunity for up-to-date, UK-specific information on kidney transplant survival and risk factors for graft loss. Moreover, as we intend to analyse children as well as young adults, information gained from this project will highlight high-risk periods for graft loss that may extend beyond the paediatric period. This work will serve to support future patient-professional discussions relating to timing and survival of kidney transplantation and will inform the use of future interventions targeting graft loss.