En-Bloc Kidney Transplantation in Children Over a 33-year Period in USA – A Comparative Study
1Abdominal Transplant Surgery, Guy's Hospital, London, London, United Kingdom, 2Department of HPB Surgery and Liver Transplantation, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, United Kingdom, 3Transplantation, Guy's and St Thomas Hospitals NHS Trust and King's College London, London, United Kingdom, 4Guy's Hospital, London, United Kingdom, 5Great Ormond Street Hospital, London, United Kingdom
Meeting: 2022 American Transplant Congress
Abstract number: 830
Keywords: Kidney transplantation, Pediatric, Post-operative complications, Surgery
Topic: Clinical Science » Kidney » 43 - Kidney: Pediatrics
Session Information
Session Time: 5:30pm-7:00pm
Presentation Time: 5:30pm-7:00pm
Location: Hynes Halls C & D
*Purpose: En-bloc kidney transplantation is not commonly performed due to scarcity of such organs as well as due to potential technical and thrombotic problems. We reviewed the use of en-bloc kidneys transplanted in children over a 33-year period in the USA.
*Methods: Data were retrieved and analysed on en-bloc kidney transplants performed in pediatric recipients (younger than 18 years old) from October 1987 until September 2020, from the United Network for Organ Sharing database (https://unos.org/). SPSS v27 was used for statistical analysis.
*Results: 194 out 23970 pediatric kidney transplants performed during the study period were transplanted en-bloc. 192 donors were DBD and were 2 DCD (84 female and 110 male). The median donor age was 1 (IQR 1-3) and the median recipient age was 12 (IQR 5-15). The median donor height, weight and BMI were 86.4cm (IQR 75-97.1), 12.85kg (IQR 10-15) and 16.42 kg/m² (IQR 15.2-18.39) respectively. The median cold ischemia time was 18 hours (IQR 12-24). 87 recipients were female and 107 were male. The median recipient height, weight and BMI were 134.3cm (98.5-152.9), 31.9kg (IQR 16.2-49) and 19 kg/m² (IQR 16.7-21.5) respectively. The majority were first transplants (176), but 17 were second and 1 was a third transplant. The median creatinine at discharge was 1 mg/dL (IQR 0.6-1.7). 35 out of 194 had a simultaneous liver transplant. Delayed graft function was observed in 30 patients and primary non-function in two. Graft thrombosis was observed in 13 (6.7%) of the en-bloc cases and in 445 (1.9%) of the non en-bloc cases (P<0.001). At last status, death censored graft failure was 89 out of 194. The graft median survival was 1991 days (IQR 377-3725) versus 2134 (IQR 855-3908) for the non en-bloc group. In addition, 26 patients (13.4%) died in the en-bloc group (8 with a functioning graft). The patient median survival was 2532 days (IQR 814-4370) in the en-bloc group versus 2602 days (IQR 1199-4443) in the non en-bloc group. Survival analysis using Kaplan-Meier did not show a significant difference between these two groups with respect to graft and patient survival (Log Rank p=0.101 and 0.179 respectively).
*Conclusions: This is a large study of prospectively collected data, describing the outcomes of 194 en-bloc kidney transplants in pediatric recipients. Generally, these organs are transplanted in older and bigger children. The risk of thrombosis is higher in the en-bloc group where graft and patient survival is similar to the non en-bloc group.
To cite this abstract in AMA style:
Gogalniceanu P, Kostakis ID, Chandak P, Papadakis G, Stojanovic J, Calder F, Loukopoulos I, Kessaris N. En-Bloc Kidney Transplantation in Children Over a 33-year Period in USA – A Comparative Study [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/en-bloc-kidney-transplantation-in-children-over-a-33-year-period-in-usa-a-comparative-study/. Accessed May 16, 2025.« Back to 2022 American Transplant Congress