Transplantation of pediatric kidneys to adult recipients: an analysis of 13 cases.
BACKGROUND
The shortage of cadaveric donors for kidney transplantation has prompted many centers to expand the criteria used for donor selection to increase the organ supply. The use of cadaveric pediatric kidneys has been suggested as a means to overcome the shortage. However, some studies indicate that kidneys from pediatric donors show inferior results to those from adult donors. In this retrospective study we examined the outcome of kidney transplantation using cadaveric pediatric donors.


METHODS
From October 1990 to May 2002, 13 adult patients received pediatric renal transplants including two that were transplanted en bloc. The patients were divided into two groups based upon donor age: group I donors were 18 months to 6 years old; the seven recipients were of mean age 47.3 years. Group II donors were 7 to 15 years old; the six recipients were of mean age 43.6 years old. Cyclosporine-based immunosuppressive regimens were used in both groups.


RESULTS
The patient survival rate was 85.7% in group I and 100% in group II. The graft survival rates at the first and third posttransplant year in group I were 71.4% (5/7) and 57.1% (4/7) and in group II, 66.7% and 50%, respectively. The frequency of urinary complications in group I was 28.5% (2/7) and in group II 33.3% (2/6). There was one case of venous thrombosis in group II.


CONCLUSIONS
Pediatric renal grafts may be used with reasonable safety. However, surgical complications remain a significant problem especially with younger pediatric grafts.
Drakopoulos
S
S
Transplantation Unit, Evangelismos General Hospital of Athens, Athens, Greece.
Koukoulaki
M
M
Vougas
V
V
Apostolou
T
T
Hadjiyannakis
E I
EI
Hadjiconstantinou
V
V
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation / Q000502:physiology*; D008875:Middle Aged; D014019:Tissue Donors / Q000706:statistics & numerical data*; D016896:Treatment Outcome