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Single Kidney Transplantation Using Pediatric Donor Kidneys: Satisfactory Outcomes but Specific Attentions Needed

M. Huang, W. Wu, X. Su, J. Li, C. Wu, H. Zhang, Q. Fu, J. Li, S. Wu, Y. Chen, Q. Zhang, L. Liu, C. Wang

The First Affiliated Hospital Of Sun Yat-sen University, Guangzhou, China

Meeting: 2022 American Transplant Congress

Abstract number: 832

Keywords: Graft function, Pediatric, Rejection, Risk factors

Topic: Clinical Science » Kidney » 43 - Kidney: Pediatrics

Session Information

Session Name: Kidney: Pediatrics

Session Type: Poster Abstract

Date: Saturday, June 4, 2022

Session Time: 5:30pm-7:00pm

 Presentation Time: 5:30pm-7:00pm

Location: Hynes Halls C & D

*Purpose: Utilization of pediatric donor in single kidney transplantation (SKT) are popular and can greatly expand the scarce donor pool, whereas potential risk factors remain unclear, which is crucial for improving post-transplant prognosis.

*Methods: A total of 484 SKTs cases using pediatric donor kidneys performed in our center from Jan 2012 to Mar 2021 were retrospectively analyzed. Recipients were grouped by age: child (0-12y, n=143), adolescence (12-18y, n=86), adult (≥18y, n=255). Overall prognosis was analyzed and post-transplant outcomes between groups were compared and assessed by univariate and multivariate analysis using Cox proportional risk model.

*Results: The average follow-up time was 30 months. 1- and 3-year patient survival were 98.7% and 96.8%, respectively. One-year and three-year death-censored graft survival (DCGS) were 96.1% and 92.7%, respectively. Overall eGFR at 1-year and 3-year are 80.0±24.5 and 84.2±25.2 mL/min/1.73 m2, and the 3-year eGFR of three groups were comparable and all were over 80 mL/min/1.73 m2, showing satisfactory graft function . Proteinuria decreased gradually within the six months post-transplant in all groups. Rejection was an independent risk factor of death-censored graft failure within three years after transplantation (HR=3.64, P=0.002). Further subgroup analysis showed surgical related complications are more common in child group than adult group (P=0.027), suggesting that surgical related complications may associate with graft failure in child recipients in 0-30 days post-transplant.

*Conclusions: Single pediatric donor kidney transplantations could achieve decent outcomes while it should be noted that rejections were persistent obstacles in the early-middle post-transplant stage. In addition, child recipients may compromise their early postoperative outcomes for surgical related complications. This study indicated risk factors in different recipient age at different post-transplant time periods, suggesting that specific attentions should be paid for different patients at different time in order to ensure the post-transplant outcomes.

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To cite this abstract in AMA style:

Huang M, Wu W, Su X, Li J, Wu C, Zhang H, Fu Q, Li J, Wu S, Chen Y, Zhang Q, Liu L, Wang C. Single Kidney Transplantation Using Pediatric Donor Kidneys: Satisfactory Outcomes but Specific Attentions Needed [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/single-kidney-transplantation-using-pediatric-donor-kidneys-satisfactory-outcomes-but-specific-attentions-needed/. Accessed May 9, 2025.

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