Long-term outcome of adults who undergo transplantation with single pediatric kidneys: how young is too young?
OBJECTIVE
The optimal donor age for transplanting a single pediatric kidney in an adult recipient remains unknown. En block kidney transplantation is usually performed when the donor age is <5 yr.


METHODS
We compared the outcomes of adult patients who underwent transplantation with single pediatric kidneys from donors who were younger than 5 yr (group 1, n = 40) and from donors who were aged 5 to 10 yr of age (group 2, n = 39) in our center.


RESULTS
The donor kidney sizes were significantly smaller in group 1 than in group 2 (P < 0.001), and group 1 required more ureteral stents than group 2 (73 versus 38%). The surgical complications, delayed graft function, and development of proteinuria were similar in both groups. Group 1 had slightly higher rejection episodes than group 2 (25 versus 18%; P = 0.67), and graft function was comparable in both groups. There were no statistical differences between the two groups in patient (P = 0.73) or death-censored graft (P = 0.68) survivals over 5 yr.


CONCLUSIONS
Single pediatric kidney transplants from donors who are younger than 5 yr can be used with acceptable complications and long-term outcomes as those from older donors.
Zhang
Rubin
R
Department of Medicine, School of Medicine, Tulane University, New Orleans, Louisiana, USA. rzhang@tulane.edu
Paramesh
Anil
A
Florman
Sandy
S
Yau
C Lillian
CL
Balamuthusamy
Saravanan
S
Krane
N Kevin
NK
Slakey
Douglas
D
D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D051799:Delayed Graft Function / Q000209:etiology; D005260:Female; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects / Q000401:mortality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011507:Proteinuria / Q000209:etiology; D018570:Risk Assessment; D017741:Survivors; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome
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