Influence of donor and recipient ages and sex on graft function after pediatric renal transplantation.
BACKGROUND
Adult donor grafts adapt to the smaller size of the child recipient by reducing their absolute glomerular filtration rate (GFR) (ml/min). The question arises whether these grafts can increase the absolute GFR when the child recipient grows or whether a child donor graft can better increase its function. The aim of this study was to evaluate the influence of donor and recipient ages and sex on renal function.


METHODS
Eighty-five children and adolescents, aged 0.4-20.5 years at transplantation, were monitored annually, by GFR and effective renal plasma flow (ERPF), determined by clearances of inulin and para-aminohippuric acid. The patients received 90 grafts from donors aged 3-67 years. Follow-up time was around 5 years.


RESULTS
Absolute GFR and ERPF (ml/min) of grafts from donors <20 years of age (all cadaveric donor grafts) increased during follow-up, resulting in a constant relative GFR and ERPF (ml/min/1.73 m2), whereas absolute GFR and ERPF of grafts from donors >20 years of age remained constant during follow-up, resulting in a significant decrease in relative values. Relative GFR and ERPF fell during follow-up in young recipients (<12 years of age), but remained constant in older recipients (>12 years). Donor and recipient sex did not influence renal function.


CONCLUSIONS
Child donor grafts seem better able to increase their function with the growth of the child recipient than adult grafts. However, the limited access to pediatric grafts and the fact that pediatric cadaveric grafts might involve technical problems in connection with grafting restrict their use.
Berg
U B
UB
Department of Pediatrics, Huddinge Hospital, Sweden. ulla.berg@mailbox.swipnet.se
Bohlin
A B
AB
Tydén
G
G
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007668:Kidney / Q000098:blood supply; D016030:Kidney Transplantation / Q000502:physiology*; D019520:Living Donors; D008297:Male; D012039:Regional Blood Flow; D012737:Sex Factors; D014019:Tissue Donors