Introduction: The use of pediatric en-bloc kidneys obtained from infant donors of very small size has previously been investigated. Some transplantation centers have under-utilized very small kidneys due to concerns regarding allograft function and growth, as well as surgical complications. We report our outcomes with transplantation of tiny en-bloc kidneys obtained from infant donors less than one year of age and compare these to outcomes from larger donors.
Methods: We reviewed our transplantation database from 2000 to 2012 to identify renal transplant recipients who received an en-bloc pair of kidneys from pediatric donors 4 years of age or less. We examined recipient characteristics, transplant characteristics, surgical complications, and allograft survival and function. The outcomes of organ recipients obtained from donors less than one year of age were compared with those of en-bloc kidneys obtained from donors between one and 4 years.
Results: 20 en-bloc kidney pair recipients were identified of which six were obtained from donors less than one year of age (mean age 8.3 ± 2.4 months), the remainder being obtained from donors between one and four (mean age 25.8 ± 10.3 months). Five out of six allografts obtained from donors less than one year of age are currently functioning. Mean GFR of 90.0 ± 30.2 mL/minute which was the same as the recipients of older allografts (77.3 ± 39.1 mL/minute) at one year follow-up.
Delayed graft function (DGF) was similar between groups. Starting volume was significantly smaller in the less than one group (35.2 ± 10.5 cm3 versus 55.8 ± 17.9 cm3, p = 0.0011). Both groups demonstrated remarkable volumetric growth (253.2% and 198.3% in the less than one and over 1 year groups respectively) within the first year post transplantation.
Conclusions: In this analysis we demonstrate successful transplantation of tiny pediatric en-bloc kidneys from very young recipients less than 1 year of age. Outcomes at 1 year which are comparable to recipients of older donors. Both groups show excellent graft function at one year, have acceptable complication and DGF rates as well as overall graft survival.
To cite this abstract in AMA style:Rowe N, Dion M, Shum J, Weernink C, Sener A, Luke P. Comparison of Pediatric En-Bloc Renal Allograft Growth and Function for Donors Less Than One Year of Age with Older Pediatric Donors [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/comparison-of-pediatric-en-bloc-renal-allograft-growth-and-function-for-donors-less-than-one-year-of-age-with-older-pediatric-donors/. Accessed June 2, 2020.
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