Assessment of factors determining graft size in transplant of cadaver kidneys from child donors.
BACKGROUND
Kidneys from child donors are very efficient at adapting to the recipient organism. This research aims to verify the size of kidney grafts from pediatric donors after transplant and to identify factors responsible for the size attained by these kidneys. Moreover, it aims to seek relationships between size and function of the transplanted pediatric kidney.


METHODS
Seventy-seven renal transplants performed at least 6 months earlier, with cadaver donor 15 years old or younger, had ultrasound measurements of the graft and renal function assessment. Potential factors for graft volume were analyzed using bivariate analysis, followed by multiple linear regression.


RESULTS
After a follow up of 4.2+/-3.3 years posttransplant, the grafts presented the following range of measures: length 10.61+/-1.13 cm, width 4.67+/-0.84 cm, and depth 4.76+/-0.99 cm. Graft volumes were 126.62+/-47.76 cm. Bivariate analysis showed that (1) age of both donor and recipient at transplantation; (2) sex of recipient; (3) occurrence of acute rejection episodes were statistically significant. After multivariate analysis, age and sex of recipients were the only significant factors influencing graft volume; child kidneys reached greater volumes when transplanted into adult and male individuals. Larger volume kidneys presented significantly more proteinuria. No difference was evident with regard to creatinine clearance values or urinary retinol binding protein among kidneys of differing sizes.


CONCLUSIONS
The size of the recipient (age and sex) is the main factor responsible for volumes achieved by kidneys from pediatric donors. The volume attained by these kidneys demonstrated no relationship with glomerular or tubular function of the organ.
Nephrology Division, Universidade Federal de São Paulo, Hospital do Rim e Hipertensão, Rua Botucatu 740, São Paulo-SP, 04023-900 Brazil. glfeltran@uol.com.br
Luciana de Santis
Lde S
Feltran
Paulo Cesar Koch
PC
Nogueira
Ana Paula
AP
Bocaletti
Dejaldo Marcos Jesus
DM
Christofalo
Sergio Aron
SA
Ajzen
Alvaro
A
Pacheco-Silva
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002102:Cadaver; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007668:Kidney / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014019:Tissue Donors; D014463:Ultrasonography; D014552:Urinary Tract Infections / Q000453:epidemiology