title: Donation after cardiac death pediatric en bloc renal transplantation.
abstract: OBJECTIVE
  Use of small pediatric kidneys obtained from extremely young donors after cardiac death has been limited. This potential organ source remains under used by transplant teams.
  
  
  METHODS
  We reviewed all renal transplants at our institution from 2000 to 2013 to identify recipients of an en bloc pair of kidneys from deceased pediatric donors younger than 4 years. The outcomes of donation after cardiac death en bloc allografts were compared with neurological determination of death en bloc allografts.
  
  
  RESULTS
  A total of 21 recipients of en bloc renal allografts were identified, of which 4 organ pairs were obtained through donation after cardiac death. Mean ± SD donor age was 20.6 ± 11.6 months and weight was 12.4 ± 3.7 kg. Delayed allograft function occurred in 2 of 4 recipients of allografts obtained from donation after cardiac death en bloc and 3 of 17 recipients of allografts from neurological determination of death en bloc. One year after transplantation mean ± SD glomerular filtration rates were similar, at 80.7 ± 15.3 and 85.7 ± 33.4 ml/minute/1.73 m(2) in the cardiac and neurological allograft groups, respectively (difference not significant). Surgical complications occurred in 3 patients, and no allograft was lost to thrombosis.
  
  
  CONCLUSIONS
  We report successful transplantation of a small cohort of pediatric en bloc kidneys obtained through donation after cardiac death from donors younger than 4 years. Outcomes at 1 year are comparable to those in neurological determination of death en bloc allograft recipients.
authors: Department of Surgery, Division of Urology, Western University, London, Ontario, Canada.
authors: Marie
authors: M
authors: Dion
authors: Department of Surgery, Division of Urology, Western University, London, Ontario, Canada; Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada.
authors: Neal
authors: N
authors: Rowe
authors: Department of General Surgery, Western University, London, Ontario, Canada; Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada.
authors: Jeffrey
authors: J
authors: Shum
authors: Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada.
authors: Corinne
authors: C
authors: Weernink
authors: Department of Surgery, Division of Urology, Western University, London, Ontario, Canada; Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada.
authors: Sarah
authors: S
authors: Felbel
authors: Department of General Surgery, Western University, London, Ontario, Canada; Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada.
authors: Vivian C
authors: VC
authors: McAlister
authors: Department of Surgery, Division of Urology, Western University, London, Ontario, Canada; Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada.
authors: Alp
authors: A
authors: Sener
authors: Department of Surgery, Division of Urology, Western University, London, Ontario, Canada; Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada. Electronic address: Patrick.Luke@lhsc.on.ca.
authors: Patrick P
authors: PP
authors: Luke
mesh_terms: D000367:Age Factors; D003643:Death; D006085:Graft Survival; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation; D011183:Postoperative Complications; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement
keywords: donor selection; kidney transplantation; tissue and organ procurement