Successful transplantation of single kidneys from pediatric donors weighing less than or equal to 10 kg into standard weight adult recipients.
BACKGROUND
The outcomes of single kidneys transplanted from pediatric donors into standard adult recipients (>60 kg) are unknown. Furthermore, the outcomes of single kidneys transplanted from pediatric donors less than or equal to 10 kg are also unknown.


METHODS
We retrospectively compared 27 recipients of single kidneys from pediatric donors younger than or equal to 5 years with 69 recipients of adult cadaveric kidneys.


RESULTS
The mean pediatric kidney recipient weight was 69 kg. Two-year patient and graft survival in pediatric kidney recipients was 100% and 92.5% respectively, compared with 98.5% and 89.8% in adult kidney recipients (P=NS). Mean time (days) to achieve creatinine less than 3 mg/dL was 14+/-9 compared with 14+/-20 in adult kidney recipients (P=NS). Estimated glomerular filtration rate at discharge, 6, 12, 18, and 24 months was equivalent in both cohorts. Stratifying pediatric kidney recipients by donor weight, there were no differences in acute rejection or graft loss in recipients of kidney from donors less than or equal to 10 kg (n=11; mean weight=8.85 kg), but there was a higher incidence of delayed graft function (7 of 11 vs. 1 of 16; P=0.002). Estimated glomerular filtration rate at discharge, 6, 12, 18, and 24 months was equivalent in both cohorts.


CONCLUSIONS
Single pediatric kidneys from donors younger than or equal to 5 years can be transplanted into standard adult recipients without compromising outcomes. Transplanting single kidneys from pediatric donors less than or equal to 10 kg into standard adult recipients is associated with an increased risk of delayed graft function; however, this does not compromise 2-year graft survival or function.
Balachandran
Vinod P
VP
1Division of Transplant Surgery, Department of Surgery, New York-Presbyterian Hospital, Weill Medical College of Cornell University, New York, NY, USA.
Aull
Meredith J
MJ
Goris
Maria
M
Figueiro
Jose
J
Leeser
David B
DB
Kapur
Sandip
S
D000328:Adult; D001835:Body Weight; D002102:Cadaver; D002648:Child; D002675:Child, Preschool; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007674:Kidney Diseases / Q000145:classification / Q000601:surgery; D016030:Kidney Transplantation / Q000276:immunology / Q000379:methods / Q000502:physiology*; D008875:Middle Aged; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014019:Tissue Donors
D007166:Immunosuppressive Agents