title: Transplantation of adult-sized kidneys in low-weight pediatric recipients achieves short-term outcomes comparable to size-matched grafts.
abstract: Low-weight pediatric recipients are disadvantaged by scarcity of size-matched donors. ASK have been successfully used for pediatric recipients. We report the results of renal transplantation using ASK in low-weight pediatric recipients and compare outcomes in weight-matched and unmatched donor-recipient pairs. The outcomes of renal transplants using ASK grafts in low-weight (<20 kg) recipients from a single center over a 10-yr period were reviewed. Two groups, comprising recipients of grafts from weight-matched and mismatched donors, were compared. Primary outcome was one-yr graft survival. Secondary outcomes were one- and two-yr calculated eGFR, changes in recipient body weight, perioperative cardiovascular stability, rates of AR and DGF. Twenty-three low-weight recipients were transplanted. Eleven received ASK grafts from high-weight donors and 12 grafts from low-weight donors. One patient in each group had early graft loss. No significant difference was observed in rates of DGF, AR, one-yr graft or patient survival and perioperative cardiovascular parameters. ASK with considerable donor:recipient weight discrepancies can be safely transplanted into small pediatric recipients with comparable outcomes to grafts with less weight discrepancy.
authors.affiliation: Division of Surgery, Department of Transplant Surgery, St James's University Hospital, Leeds, UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Goldsmith
authors.forename: S
authors.initials: S
authors.lastname: Asthana
authors.forename: M
authors.initials: M
authors.lastname: Fitzpatrick
authors.forename: E
authors.initials: E
authors.lastname: Finlay
authors.forename: M S
authors.initials: MS
authors.lastname: Attia
authors.forename: K V
authors.initials: KV
authors.lastname: Menon
authors.forename: S G
authors.initials: SG
authors.lastname: Pollard
authors.forename: D M
authors.initials: DM
authors.lastname: Ridgway
authors.forename: N
authors.initials: N
authors.lastname: Ahmad
mesh_terms: D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D009929:Organ Size; D010372:Pediatrics / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D016896:Treatment Outcome