title: Kidney transplantation from pediatric donors: size-match-based allocation.
abstract: Use of kidneys from pediatric donors has been associated with worse outcome. We review our 20-yr experience using pediatric kidneys as single grafts in children and adult recipients. Charts review of 29 recipients, transplanted between 1986 and 2005, who received a graft from a donor <or=6 yr was performed. One recipient received "en bloc" graft and the remaining patients received a single kidney. Nine recipients were adults and 21 were children. Creatinine at discharge and at follow-up was recorded and actuarial graft and patient survivals were calculated using life table analysis. All 29 recipients are alive at mean follow-up of 92 months. Five grafts were lost for: primary non-function (1), recurrent FSGS at 14 month (1) and chronic rejection (3). All five recipients who lost their graft received a graft from donors <or=3 yr. Mean calculated GFR (Schwartz formula) at one and five yr were 84.2 mL/m(2)/1.73 and 98.3 mL/m(2)/1.73, respectively. Actuarial graft survival was 93.2%, 89.6%, and 81.9% at one, five and at 10 yr after transplant. The use of a single kidney graft from pediatric donors yields good long-term results. Kidneys from small pediatric donors should be allocated first to matched-weight recipients but otherwise can be transplanted in older children or in adults.
authors.affiliation: Department of Transplantation, Schneider Children Medical Center of Israel, Petah-Tiqwa, Soraski Medical School, University of Tel Aviv, Israel.
authors.forename: Avner
authors.initials: A
authors.lastname: Bar-Dayan
authors.forename: Nathan
authors.initials: N
authors.lastname: Bar-Nathan
authors.forename: Ezra
authors.initials: E
authors.lastname: Shaharabani
authors.forename: Miriam
authors.initials: M
authors.lastname: Davidovits
authors.forename: Irit
authors.initials: I
authors.lastname: Krause
authors.forename: Roxana
authors.initials: R
authors.lastname: Kleper
authors.forename: Eytan
authors.initials: E
authors.lastname: Mor
mesh_terms: D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000378:metabolism; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery / Q000628:therapy; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003404:Creatinine