title: Optimizing the utilization of kidneys from small pediatric deceased donors under 15 kg by choosing pediatric recipients.
abstract: Currently, most kidneys from small pediatric deceased donors are transplanted into adult recipients (i.e., PTA). However, due to the weight mismatch, there is a high discard rate and a high ratio of EBKTs if adopting PTA. Here, we sought both to optimize utilization of these challenging but scarce donor grafts by selecting pediatric recipients and to characterize the feasibility and efficacy of this PTP allocation strategy. From February 2012 to October 2014, kidneys from 27 infant donors ≤ 15 kg were procured and distributed to 38 pediatric candidates in our center. The grafts were utilized for EBKT if the donor weighed 2.5-5 kg and for SKT if the donor weighed 5-15 kg, leading to 10 EBKTs and 28 SKTs. The overall utilization rate from small pediatric deceased donors was 94.12%. After a follow-up of 3-26 months, the graft survival rate was 89.47%, with four graft losses due to vascular thrombosis. Kidneys from low-body-weight donors should be applied to pediatric recipients, and the kidneys from infant donors ≥ 5 kg can be used in single-kidney-transplant procedures at experienced centers to optimize utilization.
authors.affiliation: Organ Transplantation Center, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Mingxing
authors.initials: M
authors.lastname: Sui
authors.affiliation: Organ Transplantation Center, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Wenyu
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Organ Transplantation Institute of PLA, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Organ Transplantation Institute of PLA, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Fanyuan
authors.initials: F
authors.lastname: Zhu
authors.affiliation: Organ Transplantation Center, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Youhua
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Organ Transplantation Center, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Li
authors.initials: L
authors.lastname: Zeng
authors.affiliation: Organ Transplantation Institute of PLA, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
mesh_terms: D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003643:Death; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007511:Ischemia; D016030:Kidney Transplantation; D008297:Male; D009929:Organ Size; D010372:Pediatrics; D051437:Renal Insufficiency / Q000601:surgery*; D013927:Thrombosis / Q000209:etiology; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods*
keywords: infant donors; kidney transplantation; pediatric