STUDY OF PSYCHOSOCIAL PARAMETERS RELATED TO THE SURVIVAL RATE OF RENAL-TRANSPLANTATION IN CHILDREN

The purpose of the present study was to assess the effect of intellige nce, schooling, psychomotor, emotional, and social status on renal gra ft survival in children, Sixty-two cadaver renal transplant recipients were evaluated retrospectively and the influence of sex, age, weight, and the use of cyclosporin A (CyA) on the success rate of the graft f rom 1 to 5 years later was analyzed. Psychological and social scores w ere devised and included as factors predictive of survival of the graf t. Univariate analysis showed that the following variables predicted r enal graft survival: the use of CL-A (P = 0.0002), pre-transplant dial ysis (P = 0.04), weight at the time of transplantation (P = 0.072), an d psychological scores (P = 0.064). Association analysis demonstrated that pre-transplantation dialysis was only a chance association and th erefore the parameter was discarded. Multivariate analysis showed that the predictive parameters were the use of CyA, sex, weight in kilogra ms, and the psychological score. An equation wasthen derived from vari ables that predict the probability that a specific patient's graft wil l survive more than t months. This equation is the estimated survival distribution function and is as follow: S (t) = Exp xp[-(0.8882x(1)-1. 827x(2)+0.037x(3)-0.1746x(4))+ln t-4.7862]} where S (t) = the survival at t months post transplantation, x(1) = sex (male 1, female 2), x(2) = CyA (yes 1, no 2), x(3) = weight in kilograms, and x(4) = psycholog ical score. The major impact of psychological factors on renal graft s urvival was surprising.