En bloc paediatric kidney transplant: is this the best use of a scarce resource?
BACKGROUND
Kidney transplants using organs from paediatric cadaver donors are uncommon and technically difficult. It has become accepted practice to transplant both kidneys en bloc from donors of 5 years into a single recipient. We aim to compare outcomes of en bloc kidney (EBK) transplants versus single kidney (SK) transplants from cadaver donors of age 5 years and lesser.


METHODS
Data reported to Australia and New Zealand Dialysis and Transplant Registry from 1989 to 2004 were analysed.


RESULTS
From donors 5 years of age and younger, there were 33 EBK and 38 SK transplants carried out. Overall graft survival rates at 1 and 5 years were 78 and 61%, respectively, in the EBK group and 63 and 55%, respectively, in the SK group (P = 0.94). Vascular thrombosis was the most common cause of early graft loss with an incidence of 11 and 18%, respectively, in the EBK and SK groups (P = 0.5).


CONCLUSIONS
There is a trend towards a lower vascular thrombosis rate and a better long-term graft survival in EBK transplants. These transplants will remain a technical challenge for the surgeon and EBK transplants should remain the technique of choice for donors of 5 years and lesser.
Lam
Vincent W T
VW
Department of Surgery, Westmead Hospital, Sydney, New South Wales, Australia.
Laurence
Jerome M
JM
Robertson
Paul
P
Hawthorne
Wayne
W
Ryan
Brendan J
BJ
Lau
Howard M H
HM
Allen
Richard D M
RD
Pleass
Henry C C
HC
D000328:Adult; D002675:Child, Preschool; D006085:Graft Survival; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation / Q000379:methods*; D024821:Metabolic Syndrome; D008875:Middle Aged; D014019:Tissue Donors