Transplantation of Very Small Pediatric En Bloc Renal Allografts from Donors Less Than 8 Months of Age Have Similar Outcomes to Donors More Than 8 Months
1Departments of Surgery and Transplant, London Health Sciences Centre, University Hospital, London, ON, Canada
2Microbiology and Immunology and Matthew Mailing Center for Transplant Studies, London Health Sciences Centre, University Hospital, London, ON, Canada
3Departments of Surgery and Transplant, Western University, London, ON, Canada.
Meeting: 2018 American Transplant Congress
Abstract number: B220
Keywords: Cadaveric organs, Kidney transplantation, Pediatric
Session Information
Date: Sunday, June 3, 2018
Session Name: Poster Session B: Kidney: Pediatrics
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Purpose: Few programs use kidneys from donors with body weight (BW) less than 10 kg or less than 8 months of age, for fear of complication and inadequate renal functional capacity.
Objective: We hypothesized that pediatric en bloc transplants from donors with body weight (BW) less than 10 kg, or less than 8 months of age would provide similar transplant outcomes to larger grafts.
Methods: All pediatric en bloc renal transplants performed at our center between 2001 and 2017 were reviewed (N=28). In 2010, we started to use donors smaller than 10 kg or younger than 8 months. All donors < 8 months were less than 10 kg. Data were stratified by donor BW less than (N=11) or greater than 10 kg (N=17). Demographic data of the donors and recipients were compared by donor BW. Outcomes included graft failure and delayed graft function. Renal volume was assessed during annual follow-up by ultrasound.
Results: Demographic characteristics were similar between the two groups of recipients. The 4 youngest donors utilized were 2 weeks old or younger and the oldest was 4 years old. After mean follow-up of 44 months for smaller donors and 124 for larger donors, graft and patient outcomes were similar between both groups. Mean serum creatinine at 1, 3, and 5 years was 100, 90, and 82 umol/L in the smaller group which was no different from the larger group at 102, 89, and 79, respectively. At 1-day post-transplant mean total renal volume in the smaller group was 50 ± 23 cm3 while in the larger group it was 99 ± 39 cm3 (P < 0.01). By 3 weeks, it was 73 ± 18 cm3 and 143 ± 47 cm3 in the smaller and larger groups respectively (P < 0.01). At 1 year post-transplant, mean renal volume was 125 ± 75 cm3 and 216 ± 58 cm3 (P = NS). Complication rates were similar between both groups with one case of venous thrombosis in the smaller group.
Conclusion: Pediatric en bloc renal transplantation from very small donors is a potential source of additional renal allografts. With experience, outcomes are equivalent to pediatric en bloc allografts from larger pediatric donors.
CITATION INFORMATION: Aquil S., Mitrou N., McAlister V., Sener A., Luke P. Transplantation of Very Small Pediatric En Bloc Renal Allografts from Donors Less Than 8 Months of Age Have Similar Outcomes to Donors More Than 8 Months Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Aquil S, Mitrou N, McAlister V, Sener A, Luke P. Transplantation of Very Small Pediatric En Bloc Renal Allografts from Donors Less Than 8 Months of Age Have Similar Outcomes to Donors More Than 8 Months [abstract]. https://atcmeetingabstracts.com/abstract/transplantation-of-very-small-pediatric-en-bloc-renal-allografts-from-donors-less-than-8-months-of-age-have-similar-outcomes-to-donors-more-than-8-months/. Accessed March 1, 2021.« Back to 2018 American Transplant Congress