Single Kidney Transplantation from Small Pediatric Donors Aged < 2 Years Into Pediatric Recipients: A Retrospective Single-Center Cohort Study
Organ Transplant Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
Meeting: 2022 American Transplant Congress
Abstract number: 810
Keywords: Donors, marginal, Kidney transplantation, Outcome, Pediatric
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: Kidneys from small pediatric donors (aged < 2 years, SPD) are underutilized. Concerns regarding potentially inferior outcomes hinder the use in pediatric recipients, especially as single grafts. This study aimed to test whether pediatric recipients transplanted with single SPD kidney could achieve comparable results.
*Methods: This retrospective cohort study investigated all pediatric kidney transplantation from donors < 18 years old between 01/2012 and 05/2021 in a single specialized transplant center. Outcomes were compared using Kaplan-Meier with log-rank test. The relative graft prognostic utility was assessed using multivariable Cox proportional hazard model, adjusted for potential risk factors.
*Results: Of all 252 enrolled patients, 149 (59.13%) were transplanted from elder single donor (ESD, aged ≥ 2 years), 90 (35.71%) from small single donor (SSD), and 13 (5.16%) from small en bloc donor (SEBD). All groups demonstrated satisfactory graft function, eGFR at 2 years posttransplant was 89.01±28.06, 93.53±26.04, 90.42±23.34 mL/min/1.73 m2 for ESD, SSD, and SEBD groups, respectively (P = 0.685). Patients were followed for a median of 26.29 months after transplantation, during which 27 (10.71%) grafts were lost, and 2 (0.79%) patients died of pulmonary infection. The most common causes of graft loss were rejection (48.15%), vascular thrombosis (22.22%), and recurrent disease (11.11%). Two-year graft survival in the SSD group was 88.78%, comparable to the results in the ESD and SEBD groups (93.62% and 92.31%, P = 0.433). The adjusted hazard ratio (aHR) for graft loss was similar for recipients of SSD (aHR 2.77, 95% CI 0.89-8.61, P = 0.079), SEBD (aHR 1.59, 95% CI 0.16-16.28, P = 0.697) groups compared with ESD group.
*Conclusions: Kidneys from SPDs have at least as good short-term outcomes as elder pediatric donors even when transplanted as single allografts into children. This study provides evidence to support a lower age limit for pediatric single kidney transplantation from SPDs.
To cite this abstract in AMA style:
Zhang Q, Huang M, Li J, Wu W, Zhang H, Wu C, Fu Q, Gao P, Ling L, Chen W, Xu B, Su X, Liu L, Wang C. Single Kidney Transplantation from Small Pediatric Donors Aged < 2 Years Into Pediatric Recipients: A Retrospective Single-Center Cohort Study [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/single-kidney-transplantation-from-small-pediatric-donors-aged-2-years-into-pediatric-recipients-a-retrospective-single-center-cohort-study/. Accessed May 9, 2025.« Back to 2022 American Transplant Congress