Long-term outcomes of single paediatric vs. ideal adult renal allograft transplants in adult recipients.
OBJECTIVE
To compare the outcomes of single paediatric vs. adult kidneys transplanted into adult recipients.


METHODS
A retrospective single-centre review of 38 single cadaver kidney transplants from donors less than five yr of age to wait-listed patients of low body mass index (BMI). Survival of grafts and quality of renal function were compared with 121 similarly low BMI recipients of grafts from donors 18-45 yr of age that were transplanted during the same period. Immunosuppression consisted of sirolimus, minimal-dose cyclosporine and prednisone. The mean age of the paediatric vs. adult donors was 2.8+/-1.0 and 31.1+/-9.2 yr, respectively (p<0.01) and of the recipients, 42.0+/-12.4 and 45.7+/-14.8 yr, respectively (p=NS). The mean BMI of paediatric vs. adult donor kidney recipients was 21.8+/-2.9 and 22.4+/-2.0 kg/m2 (p=NS). Sixty-six per cent of paediatric donor recipients were women compared with 44% of adult donor recipients (p=0.03).


RESULTS
Death censored actuarial graft survivals at one and five yr for recipients of paediatric vs. adult donor grafts were 93 and 84% compared with 93 and 85% (p=NS). There were no graft losses because of technical complications in the paediatric kidney donor group. At one and five yr post-transplantation, the mean estimated creatinine clearances of the paediatric donor graft recipients were 52.9+/-19.6 and 54.0+/-17.8 mL/min, respectively, compared with 56.4+/-19.8 and 49.1+/-21.7 mL/min for recipients of adult donor grafts at the same times (p=NS).


CONCLUSIONS
Transplantation of single paediatric donor kidneys into low BMI adult recipients provided equivalent outcomes to those of grafts from adult donors between the ages of 18 and 45 yr.
Csapo
Zsolt
Z
Division of Immunology and Organ Transplantation, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
Knight
Richard J
RJ
Podder
Hemangshu
H
Kerman
Ronald H
RH
Schoenberg
Linda
L
Katz
Stephen M
SM
Van Buren
Charles T
CT
Kahan
Barry D
BD
D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D003404:Creatinine