Donor Risk Factors Affecting Graft Survival in Pediatric Kidney Transplants: Protocol for a Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background: Pediatric patients with end-stage kidney disease require kidney transplants (KTs) 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 and 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, as well as the cause of death and length of hospitalization for deceased donors. The literature search will use the following databases: 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 the Stata/BE (version 19) software. Depending on data availability, subgroup analyses will be conducted based on donor type (living vs deceased). The reporting of findings will adhere to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: The search and screening for the systematic literature review are anticipated to be finished in June 2026. Data extraction, quality appraisal, and subsequent data synthesis will begin in July 2026. The review is expected to be completed by October 2026, and the study results will be published in 2027. 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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.068 | 0.107 |
| Meta-epidemiology (narrow) | 0.006 | 0.005 |
| Meta-epidemiology (broad) | 0.021 | 0.031 |
| Bibliometrics | 0.011 | 0.011 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.007 | 0.006 |
| Open science | 0.006 | 0.005 |
| Research integrity | 0.006 | 0.007 |
| Insufficient payload (model declined to judge) | 0.066 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".