[Experience with kidney transplantation with children as donors].
OBJECTIVE
To analyze the results achieved with transplantation of children kidneys to adult recipients.


METHODS
The results achieved with transplantation of children cadaver kidneys (< 15 years) from 1989 to 1994 over a follow-up period of at least 36 months were reviewed. Patients (n = 43) were stratified into group A (13 grafts from donors < or = 6 years), group B (30 grafts from donors > 6 years) and group C (control group), which comprised 73 patients who received grafts from donors of an ideal age during the same time period. All three groups were similar for variables considered to influence the results of transplantation, except for the higher incidence of hypotension in group B.


RESULTS
The number of episodes of rejection was three-fold higher in group A than in the control group (p = 0.019). A higher incidence of surgical complications, principally vascular complications (arterial thrombosis, renal rotation), was found in group A versus the control group (p = 0.039). When the grafts transplanted en bloc from donors under 12 months were excluded from the analysis, the incidence of vascular or urological surgical complications in group A was not found to be higher than that of the control group. No difference was found for mean length of stay, renal function (creatininemia), graft or patient survival for the three groups.


CONCLUSIONS
Grafts from donors more than 6 years old showed a similar behavior as those from donors of an ideal age. Furthermore, single kidneys from donors aged more than 12 months can be transplanted with excellent results. It is necessary to have a larger series to confirm and explain the high incidence of acute rejection in grafts from donors less than 6 years old.
Miñana López
B
B
Servicio de Urología, Hospital Morales Meseguer, Murcia, España. bminana@pulso.com
Fernández Aparicio
T
T
Díaz González
R
R
Polo Villar
G
G
Aguirre Benites
F
F
Fraile Gómez
B
B
Morales Cerdán
J M
JM
Leiva Galvis
O
O
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation / Q000009:adverse effects; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D014019:Tissue Donors