Date: Tuesday, June 14, 2016
Session Time: 4:30pm-6:00pm
Presentation Time: 4:30pm-4:42pm
Location: Room 302
Background: Transplantation (Tx) of PeB kidney grafts has been shown to result in good long-term outcomes. However, the fate of PeB grafts that suffer loss of one of their kidneys remains unknown.
Methods: Retrospective review was done of all PeB transplants (Txs) done at our center between 7/2003 & 10/2015.
Results: Of 240 PeB Txs, we identified 15 recipients that experienced Unilateral Loss (UL). Of these 15 ULs, 14 were due to thrombosis, 1 due to an intraop technical complication during Tx.
Donor (table1) & recipient (table 2) characteristics:
|Donor Profile||Median (range)|
|Age (months)||2.6 (0-32)|
|Wt (kg)||4.0 (1.9-17.9)|
|Final Pump Flow (ml/min)||32 (11-72)|
|Final Resistance||0.7 (0.22-3.0)|
|Recipient Profile||Median (Range)|
|Age (years)||38 (16-76)|
|Wt (Kg)||56 (32-72)|
Cold Ischemic Time (hrs)
|Donor/Recipient Wt ratio||0.07 (0.03-0.26)|
|# of days dialysis needed (func grafts)||40.5 (2-237)|
DGF rate was 53% for all grafts. 4 of 15 grafts with UL failed at 0 to 61 days post-Tx – 50% due to PNF & 50% due to thrombosis of the other kidney. 3 of the 4 failed grafts were from donors <5kg. Relaparotomy rate was 73%. Graft survival (Figure 1) for all 15 Txs, and post-Tx Cr levels for the 11 functioning grafts (Figure 2) were:
Conclusion: Despite increased surgical peri-Tx morbidity, UL in PeB grafts from donors >5kg resulted in good long term outcomes. Conversely, poorer outcomes of UL in PeB grafts <5kg, probably warrants early removal of the contralateral kidney. The excellent long-term outcomes of single grafts from small peds donors underscores the significant compensatory capacity of these PeB grafts & provides added rationale for pursuing PeB Tx from small peds donors into adult recipients.
CITATION INFORMATION: Santhanakrishnan C, Perez R, McVicar J, Sageshima J, Troppmannn C. Outcomes of Pediatric en Bloc Kidney (PeB) Grafts After Loss of a Single Kidney. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:Santhanakrishnan C, Perez R, McVicar J, Sageshima J, Troppmannn C. Outcomes of Pediatric en Bloc Kidney (PeB) Grafts After Loss of a Single Kidney. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-of-pediatric-en-bloc-kidney-peb-grafts-after-loss-of-a-single-kidney/. Accessed February 27, 2021.
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