title: Single vs dual (en bloc) kidney transplants from donors ≤ 5 years of age: A single center experience.
abstract: OBJECTIVE
  To compare outcomes between single and dual en bloc (EB) kidney transplants (KT) from small pediatric donors.
  
  
  METHODS
  Monocentric nonprospective review of KTs from pediatric donors ≤ 5 years of age. Dual EB KT was defined as keeping both donor kidneys attached to the inferior vena cava and aorta, which were then used as venous and arterial conduits for the subsequent transplant into a single recipient. Donor age was less useful than either donor weight or kidney size in decision-making for kidney utilization as kidneys from donors < 8 kg or kidneys < 6 cm in length were not transplanted. Post-transplant management strategies were standardized in all patients.
  
  
  RESULTS
  From 2002-2015, 59 KTs were performed including 34 dual EB and 25 single KTs. Mean age of donors (17 mo vs 38 mo, P < 0.001), mean weight (11.0 kg vs 17.4 kg, P = 0.046) and male donors (50% vs 84%, P = 0.01) were lower in the dual EB compared to the single KT group, respectively. Mean cold ischemia time (21 h), kidney donor profile index (KDPI; 73% vs 62%) and levels of serum creatinine (SCr, 0.37 mg/dL vs 0.49 mg/dL, all P = NS) were comparable in the dual EB and single KT groups, respectively. Actuarial graft and patient survival rates at 5-years follow-up were comparable. There was one case of thrombosis resulting in graft loss in each group. Delayed graft function incidence (12% dual EB vs 20% single KT, P = NS) was slightly lower in dual EB KT recipients. Initial duration of hospital stay (mean 5.4 d vs 5.6 d) and the one-year incidences of acute rejection (6% vs 16%), operative complications (3% vs 4%), and major infection were comparable in the dual EB and single KT groups, respectively (all P = NS). Mean 12 mo SCr and abbreviated MDRD levels were 1.17 mg/dL vs 1.35 mg/dL and 72.5 mL/min per 1.73 m(2) vs 60.5 mL/min per 1.73 m(2) (both P = NS) in the dual EB and single KT groups, respectively.
  
  
  CONCLUSIONS
  By transplanting kidneys from young pediatric donors into adult recipients, one can effectively expand the limited donor pool and achieve excellent medium-term outcomes.
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Yousef
authors.initials: Y
authors.lastname: Al-Shraideh
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Umar
authors.initials: U
authors.lastname: Farooq
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Hany
authors.initials: H
authors.lastname: El-Hennawy
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Alan C
authors.initials: AC
authors.lastname: Farney
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Amudha
authors.initials: A
authors.lastname: Palanisamy
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Rogers
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Orlando
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Khan
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Amber
authors.initials: A
authors.lastname: Reeves-Daniel
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: William
authors.initials: W
authors.lastname: Doares
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Scott
authors.initials: S
authors.lastname: Kaczmorski
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Gautreaux
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Samy S
authors.initials: SS
authors.lastname: Iskandar
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Gloria
authors.initials: G
authors.lastname: Hairston
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Brim
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Margaret
authors.initials: M
authors.lastname: Mangus
authors.affiliation: Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stratta
keywords: Donor age; Donor weight; En bloc kidney transplant; Kidney donor profile index; Single kidney transplant; Small pediatric donor