Living donor kidney transplants are rarely performed using donors less than 18y of age. There is no data on how these patients fare relative to older kidney donors. Our hypothesis was that pediatric donors would not incur increased risks of hypertension, diabetes, or reduced GFR beyond what is typically seen in donors above the age of 18. Moreover, we also hypothesized that their life span and rate of diabetes are not different than adult donors.
3698 live kidney donations were performed at our institution between 1963 and 2008. These donors were asked to provide updates on health status, urinalysis, and serum creatinine testing; 39 were pediatric donors and were matched 1:2 with donors based on year of donation, gender, relation to donor, BMI at transplant and eGFR at donation. One donor was matched 1:1 and two could not be matched due to missing weight.
For binary outcomes of donor status, prevalence of hypertension, diabetes and eGFR category, conditional logistic regression was performed to estimate the effect of being a pediatric donor.
Mean age at donation for pediatric donors was 17.1 ± 0.7 years and 48.7 ± 8.2 years at last follow-up. All were related to their recipients (12 were children, 25 were siblings, two were identical twins and one was to a cousin) and 60% were male. After a mean follow-up period of 31.6 ± 8.2 years, 37.5% of pediatric donors became hypertensive, 5% became diabetic and 95% were still alive. These proportions were not different than what was observed in matched controls. Assuringly, none of the pediatric donors had eGFR < 45 ml/min/1.73m2 and only 27.5% had eGFR < 60 ml/min/1.73m2 in contrast to 11.3% and 48.1% in matched donor controls. The results of the regression analysis are shown in table.
|Outcome||OR (95% CI) (Pediatric Donors vs Matched Dono Controls)||P- Value|
|Alive||4.28 (0.90, 20.30)||0.067|
|Current MDRD <45ml/min/1.73m²||NA||NA|
|Current MDRD <60ml/min/1.73m²||0.36 (0.14, 0.93)||0.035|
|Hypertensive||0.42 (0.17, 1.05)||0.064|
|Diabetic||0.34 (0.07, 1.59)||0.171|
Pediatric donors were not more likely to develop hypertension or diabetes and their eGFR was better than the matched controls.
After a mean follow up of 31.6 ± 8.2 years, pediatric donors are not at higher risk for hypertension or diabetes and have a significantly lower risk of developing eGFR <60.
To cite this abstract in AMA style:MacDonald D, Jackson S, Matas A, Spong R, Kukla A, Ibrahim H. Long Term Outcomes of Young (< 18 Years) Kidney Donors: A Matched Cohort Analysis [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/long-term-outcomes-of-young-18-years-kidney-donors-a-matched-cohort-analysis/. Accessed November 24, 2017.
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