Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jan 22, 2025
Date Accepted: Sep 18, 2025
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Donor Risk Factors Affecting Graft Survival in Pediatric Kidney Transplantations: Protocol for a Systematic Review and Meta-analysis
ABSTRACT
Background:
Pediatric patients with end-stage kidney disease require kidney transplants (KT) throughout their lifetime. Long-term graft survival is dependent on multiple factors which are broadly categorized as donor and recipient related factors. Advances in transplant care and changes in donor population demographics necessitate an updated analysis on donor risk factors to guide clinical decision making.
Objective:
In this systematic review/meta-analysis, we will focus on the impact of donor factors on graft survival in pediatric KT, excluding transplants from donation after circulatory death as the latter are less common in children.
Methods:
This review encompasses studies reporting donor-related risk factors for graft survival in pediatric KT, including age, size, comorbidities, and ethnicity for living and deceased donors, also the cause of death and length of hospitalization for deceased donors. The literature search will use databases including PubMed, Scopus, Web of Science, Embase, and Cochrane. Two independent reviewers will select studies and assess their quality. Pooled estimates of relevant factors will be computed via a random-effects model using Stata/BE 18 software. Depending on data availability, the subgroup analyses will be conducted based on factors such as donor type (living versus deceased) and age group. The reporting of findings will adhere to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines.
Results:
The search and screening for the systematic literature review are anticipated to be finished in August 2025. Data extraction, quality appraisal, and subsequent data synthesis will begin in September 2025. The review is expected to be completed by April 2026, and the study results will be published in 2026.
Conclusions:
Our review will provide a comprehensive synthesis of the available evidence on kidney donor risk factors impacting graft survival in pediatric KT. The results of this review could provide valuable insights for clinical decisions, policy development, and ongoing efforts to improve outcomes for children with end-stage kidney disease requiring KT. Clinical Trial: PROSPERO CRD42024500442. https://www.crd.york. ac.uk/prospero/display_record.php?ID=CRD42024500442
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