title: [Children as receptors of living donors].
abstract: The most important factor in life expectancy for children on renal replacement therapy (RRT) is to have a functioning graft when they reach adulthood (63 years&nbsp; on transplantation vs 37 years on dialysis). The pediatric recipient is very suitable for a living donor transplantation (LDT), with few contraindications. There are several reasons that make LDT the most recommended RRT in children: pre-emptive transplant avoiding dialysis, good renal mass, minimal cold ischemia time, better HLA-matching and the possibility to program the time of surgery. Long term graft survival in LDT is significantly better than in cadaveric donor transplantation (CDT) (81.3%&nbsp; LDT vs 60.8 % CDT at 10 years follow-up). Calculated half-life graft survival for recipients aged 2-5 years reaches 27.5 years in some series, making LDT the ideal option for these children. Adolescent recipients (12-17 years) have an excellent early graft survival, but the worst long term outcome compared with the rest of pediatric population. However, preemptive LDT has a 70% of graft survival at 10 years. Late rejections episodes associated with non-adherence factors are found in all series. Unrelated LDT in pediatric recipients outcome remain unclear.
authors.affiliation: Servico de Nefrologia Pediátrica, Hospital Universitaro La Paz, Madrid. mnavarro.hulp@salud.madrid.org
authors.forename: Mercedes
authors.initials: M
authors.lastname: Navarro Torres
authors.forename: Laura
authors.initials: L
authors.lastname: Espinosa Román
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D046148:Donor Selection; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D010349:Patient Compliance; D016896:Treatment Outcome