title: Outcome of single pediatric deceased donor renal transplantation to adult kidney transplant recipients.
abstract: BACKGROUND
  In times of organ shortage more kidneys were transplanted in 'expanded criteria kidney' programs. This study examines the outcome of adult kidney recipients from pediatric donors.
  
  
  METHODS
  This single-center retrospective analysis evaluated eight adult patients who received a kidney from a deceased pediatric donor (age 5-17) between 06/2000 and 09/2011.
  
  
  RESULTS
  The median donor age was 14 years (range 5-17). The median recipient age was 49 years (range 25-57). The median cold ischemia time was 13.3 h (range 4.3-20.1), while the median warm ischemia time was 53 min (range 42-60). The median follow-up was 35.8 months (range 7-142). Acute rejection was observed in 50.0% of cases. The median HLA mismatch was 2.0. The median 1-year creatinine level was 0.95 mg/dl, the uncensored 1-year graft survival was 75.0% and the 3-year graft survival 62.5%, respectively. No recipient died within the follow-up period. As severe surgical complications, one stenosis of the renal artery and one lymphocele needing surgical revision were observed.
  
  
  CONCLUSIONS
  Renal transplantation of a deceased single pediatric donor to an adult recipient can be performed safely and shows a good outcome. Wherever feasible, single pediatric kidney transplantation can double the number of recipients over an 'en-bloc' transplantation. The price for a single pediatric kidney transplant may be a higher vascular complication rate and a higher rejection risk. Despite the higher risks, transplantation of a single pediatric donor kidney should be performed when accomplishable.
authors.affiliation: Department of Urology, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Friedersdorff
authors.forename: Tom Florian
authors.initials: TF
authors.lastname: Fuller
authors.forename: Peter
authors.initials: P
authors.lastname: Werthemann
authors.forename: Hannes
authors.initials: H
authors.lastname: Cash
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D050377:Cold Ischemia; D046148:Donor Selection; D005260:Female; D005858:Germany; D006084:Graft Rejection / Q000209:etiology; D006085:Graft Survival; D006680:HLA Antigens / Q000276:immunology; D006648:Histocompatibility; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors / Q000600:supply & distribution*; D016896:Treatment Outcome; D052096:Warm Ischemia
chemical_list: D006680:HLA Antigens