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)|
|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)|
|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)|
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 June 5, 2020.
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