title: Comparable Survival of En Bloc versus Standard Donor Kidney Transplants in Children.
abstract: OBJECTIVE
  To determine whether renal transplantation survival is similar in children receiving pediatric en bloc kidneys compared with those receiving standard deceased donor kidneys.
  
  
  METHODS
  We compared time to allograft failure and estimated glomerular filtration rate (eGFR) in pediatric recipients of en bloc and standard criteria deceased donor renal transplants using Organ Procurement and Transplantation Network data for 2000-2013. Cox regression analysis was used to compare time to allograft failure, and the Student t test was used to compare eGFR.
  
  
  RESULTS
  A total of 6882 recipients met the study inclusion criteria; 1.8% received an en bloc transplant. The adjusted hazard for allograft failure was similar for recipients of en bloc kidneys compared with standard criteria kidneys (hazard ratio, 1.15; 95% CI, 0.83-1.59; P = .41). The median wait time for transplantation was significantly shorter for recipients of en bloc kidneys (157 days vs 208 days; P = .03). Moreover, eGFR was superior for recipients of en bloc kidneys up to 5 years post-transplantation.
  
  
  CONCLUSIONS
  Transplantation of en bloc pediatric kidneys should be considered a viable option for pediatric recipients and may afford unique benefits by reducing wait times and promoting preservation of graft function.
authors.affiliation: Department of Pediatrics, University of California Davis, Sacramento, CA. Electronic address: ewinnicki@ucdavis.edu.
authors.forename: Erica
authors.initials: E
authors.lastname: Winnicki
authors.affiliation: Department of Pediatrics, University of California Davis, Sacramento, CA.
authors.forename: Madan
authors.initials: M
authors.lastname: Dharmar
authors.affiliation: Department of Pediatrics, University of California Davis, Sacramento, CA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Tancredi
authors.affiliation: Department of Pediatrics, University of California Davis, Sacramento, CA.
authors.forename: Lavjay
authors.initials: L
authors.lastname: Butani
mesh_terms: D000293:Adolescent; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D002648:Child; D015331:Cohort Studies; D050377:Cold Ischemia / Q000706:statistics & numerical data; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D061665:Time-to-Treatment; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014481:United States
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents