Kidney Size Does Not Matter: Should the Decision to Split Pediatric En Bloc Donor Kidneys Be Based on Donor Weight Rather Than Kidney Length?
Division of Transplant Surgery, University of California, Davis, Sacramento, CA
Meeting: 2017 American Transplant Congress
Abstract number: C26
Keywords: Graft failure, Kidney transplantation, Pediatric, Post-operative complications
Session Information
Session Name: Poster Session C: Deceased Donor Issues II: DCD, DGF, AKI, En-Bloc
Session Type: Poster Session
Date: Monday, May 1, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background: Deceased donor kidneys from pediatric donors have been used with good results. However, there is little consensus on the criteria used to safely split peds en bloc kidneys.
Methods: We analyzed our large single-center experience with single kidney transplants from pediatric donors <20 kg performed 2005-2016 (n=46). Kidney length was used as a selection criteria.
Results: Overall 1-year graft survival was 93.5%. There were 3 graft losses, all of them in donors < 15kg and none in >15kg. All losses were due to PNF, no thrombotic events. Biopsies of the 3 failed kidneys showed evidence of hyperperfusion injury.
| Donor Profile | <15kg Mean (range) | >15kg Mean (range) |
| N | 18 | 28 |
| Age (months) | 36.8 (9-132) | 52.7 (19-154) |
| Weight (kg) | 12.6 (7-14.3) | 16.6 (15-19) |
| Final pump flow/Resistance | 46.8/0.51 | 62.8/0.52 |
| Kidney Length (cm) | 7.2 (6.0-8.0) | 7.8 (6.0-9.0) |
| Terminal Cr | 0.51 (0.2-2.9) | 0.58 (0.2-3.1) |
| DCD | 39% | 17.90% |
| Recipient Profile | <15 kg Mean (range) | ≥15 kg Mean (range) |
| Age (yrs) | 54 (22-76) | 44 (11-66) |
| Weight (kg) | 61.4 (43.1-84) | 63.4 (32.3-84.2) |
| CIT | 32.4 (6.5-53.9) | 27.2 (5.5-50.7) |
| DGF | 20% | 18% |
Conclusion: Our experience suggests pediatric kidneys recovered en bloc should be split based on donor weight rather than kidney length. Donor weight ≥15 kg thus appears to be a superior criterion to identify en bloc kidneys that can be safely split. As donor weight is a readily available pre-recovery parameter, it could be easily incorporated into the existing allocation algorithms.
CITATION INFORMATION: Perry A, Woloszyn J, McVicar J, Sageshima J, Perez R, Troppmann C, Santhanakrishnan C. Kidney Size Does Not Matter: Should the Decision to Split Pediatric En Bloc Donor Kidneys Be Based on Donor Weight Rather Than Kidney Length? Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Perry A, Woloszyn J, McVicar J, Sageshima J, Perez R, Troppmann C, Santhanakrishnan C. Kidney Size Does Not Matter: Should the Decision to Split Pediatric En Bloc Donor Kidneys Be Based on Donor Weight Rather Than Kidney Length? [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/kidney-size-does-not-matter-should-the-decision-to-split-pediatric-en-bloc-donor-kidneys-be-based-on-donor-weight-rather-than-kidney-length/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress