Pediatric kidneys have been traditionally considered marginal organs for transplantation & are underutilized given concerns of poor outcomes. Furthermore, long term outcomes of single kidneys transplanted from pediatric donors into adult recipients are unknown.

Methods. Retrospective review of 91 adults who received a deceased donor kidney transplant from 12/2005 to 4/2016 with a single kidney from a donor ≤ 5 y.o. was performed. Donor & recipient demographics were reviewed & patient & graft survival were analyzed using Kaplan-Meier survival plots.

Results. Donor age & weight were 1.6 ± 1.2 yr & 11.3 ± 3.6 kg, respectively. KDPI scores were 71 ± 10%. Recipient age was 46 ± 14 yrs, 53% were male, wait time was 1065 ± 696 days. Recipient weight & BMI were 67 ± 15 kg & 24 ± 4 kg/m2, respectively. Most common causes of ESRD were HTN (25%) & DM (19%). Cold ischemia time was 24 ± 9 hrs. Follow up time was 59 ± 38 months. Serum creatinine was 1.3 ± 0.5 mg/dL at 1 year, & 1.3 ± 1.0 at most recent follow-up. Fifteen graft losses occurred due to rejection (n=4), death with function (n=3), primary non-function (n=2), infection (n=2), medical issues (n=2), thrombosis (n=1) & unknown (n=1).

Figure 1: Patient Survival

Figure 2: Graft Survival

Note, listed along side the KM graft survival is the predicted graft survivals for a KDPI of 70% (closest to the KDPI of our donor cohort)

Conclusions. Single pediatric kidneys from donors ≤ 5 years old can be transplanted into adult recipients with excellent outcomes. The graft survival of these organs is better than would be predicted by their KDPI scores and thus should be considered an important resource for reducing the organ shortage.

CITATION INFORMATION: Shah R., Aull M., Watkins A., Kapur S. Excellent Long Term Outcomes Transplanting Single Pediatric Kidneys from Donors Five Years and Younger into Adult Recipients Am J Transplant. 2017;17 (suppl 3).

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