A prospective study on size and function of paediatric kidneys (<10 years) transplanted to adults.
BACKGROUND
There is increasing evidence that paediatric kidneys transplanted to adults have good graft function and satisfactory graft survival. The relationship between size increment and functional potential of paediatric kidneys following transplantation is not defined in detail. We therefore initiated a prospective single centre study, comprising detailed and repeated measurements of size and function of paediatric kidneys transplanted to adults.


METHODS
Nineteen adults receiving a first kidney transplant from a paediatric donor (<10 years of age) were included in the study. All patients were followed for 12 months post-transplant. Increment in size and function of the transplanted kidneys were assessed by ultrasound, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). All tests were performed during the first week, post-transplant and subsequently repeated at 1, 3, 6 and 12 months.


RESULTS
Kidney volume increased 2.6-fold at 12 months (P < 0.001). GFR and ERPF showed a slightly more moderate increase, 1.8-fold and 1.6-fold, respectively. Patient and graft survival at 1 year were 100% and serum creatinine was 91 micromol/l (66-169).


CONCLUSIONS
The study indicates that paediatric kidneys for transplantation may be considered as excellent rather than being referred to as suboptimal for adult recipients, at least the first year after transplantation.
Foss
Aksel
A
Department of Surgery, Section of Transplant Surgery, Rikshospitalet, N-0027 Oslo, Norway. akselfoss@rikshospitalet.no
Line
Pål-Dag
PD
Brabrand
Knut
K
Midtvedt
Karsten
K
Hartmann
Anders
A
D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007223:Infant; D007668:Kidney / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000254:growth & development / Q000502:physiology*; D016030:Kidney Transplantation / Q000000981:diagnostic imaging / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000502:physiology; D011446:Prospective Studies; D017596:Renal Plasma Flow, Effective / Q000502:physiology; D014463:Ultrasonography