Pediatric Recipients of Deceased Adult Donor Kidneys Have Equivalent Outcomes Compared with Pediatric Donors.

D. Mikhail,¹ H. Sharma,^3,4 J. Chen,² M. Cooper,⁴ A. Sener,^1,3 P. Luke.^1,3

¹Urology, Western University, London, ON, Canada
²Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
³Multi-Organ Transplant Surgery, Western University, London, ON, Canada
⁴Transplant Surgery, Georgetown University, Washington, DC

Meeting: 2017 American Transplant Congress

Abstract number: D168

Keywords: Age factors, Graft survival, Kidney transplantation, Pediatric

Session Information

Session Name: Poster Session D: Kidney: Pediatric

Session Type: Poster Session

Date: Tuesday, May 2, 2017

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall D1

INTRODUCTION:

Efforts are made to transplant paediatric deceased donor kidneys into pediatric recipients. To our knowledge, data does not support better graft outcomes with matched pediatric deceased donor transplants. We hypothesize that deceased donor kidneys from Pediatric Donors (under 18 years), have better long term graft outcomes compared to those received from adult donors.

METHODS: Donor and recipient data for transplants carried out between 2005-2010 was obtained from the UNOS database which was complete to March 2013. We identified all recipients that were 17 years of age and younger. We excluded recipients under 4 years and donors for whom KDRI (Kidney Donor Risk Index) variables were missing. Delayed Graft Function (DGF) and Death Censored Graft Survival (GS) outcome data was analyzed based on donor age ≤17 (Pediatric Donors) compared to donors 18 and older (Adult Donors). Matched-Pair analysis was performed. Graft Survival were compared using Kaplan-Meier curves and Cox-regression multivariate analysis.

RESULTS:

Overall, 3034 pediatric kidney transplant recipients were identified, 10% were <4 years. Our matched pair analysis based on KDRI left us with 670 (26%) Pediatric Donors and 1878 (74%) Adult Donors. Average recipient age, sex and other factors were similar. Mean pediatric donor age was 13.7 years (CI 13.4 to 14) while mean adult donor age was 24.6 years (CI 24.3 to 24.8). DGF was not significantly different between the two groups (11% vs. 9%), although DCD adult donors have higher DGF (25% vs 10%, p=0.04). DCGS for the Pediatric and Adult groups were similar (p=0.08) at 1 year (95.2% vs. 94.9%) and median follow-up of 3.3 years (87.5% vs. 85.5%). Multivariate Cox-regression analysis showed that DGF (HR = 2.55) as well as recipient factors were associated with graft survival.

DISCUSSION: Analysis of pediatric deceased donor renal transplant recipients in the UNOS database shows no significant difference in delayed graft function nor graft survival when comparing pediatric and adult donors. Recipient factors and presence of DGF correlate with graft survival. Adult and Pediatric deceased donors are both associated with excellent outcomes in pediatric renal transplant recipients.

CITATION INFORMATION: Mikhail D, Sharma H, Chen J, Cooper M, Sener A, Luke P. Pediatric Recipients of Deceased Adult Donor Kidneys Have Equivalent Outcomes Compared with Pediatric Donors. Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Mikhail D, Sharma H, Chen J, Cooper M, Sener A, Luke P. Pediatric Recipients of Deceased Adult Donor Kidneys Have Equivalent Outcomes Compared with Pediatric Donors. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/pediatric-recipients-of-deceased-adult-donor-kidneys-have-equivalent-outcomes-compared-with-pediatric-donors/. Accessed November 22, 2024.

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