*Purpose: Paediatric donors have been contributing to the kidney donor pool but there are concerns regarding the small nephron mass, hyperfiltration, technical issues including risks of thrombosis and long-term outcomes. We present UK national outcomes data for these paediatric kidneys.

*Methods: Retrospective analysis of National Health Service Blood and Transfusion (NHSBT) database for paediatric kidney donors from 2007-2016. The cohort of paediatric donors was further divided into ≤ 5 and >5 years for analysis.

*Results: Total of 631 paediatric (<18 years) kidney transplants were performed in the study period (single and en-bloc).

There were no statistical differences in the recipient age (36.0years v 35.9years), cold ischaemic times (14.2hours v 15.1hours) or the anastomotic times (39.1min v 38.8mins) between ≤ 5 and >5-year-old donor groups. The graft function (immediate, DGF or primary non-function rates) and the 12 months eGFRs (82.4 v 78.0) were also similar.

82.7% of the en-bloc kidney transplants were from ≤5 years old donors.

The graft survival rates were similar between the two donor age groups, between en-bloc and single kidney transplants and among donor types (DBD v DCD); overall and in single kidney groups. En-bloc DCD kidneys had worse graft survival (p 0.0007) compared to DBD donors.

*Conclusions: Paediatric kidney donors remain a precious source of renal allografts with excellent one-year eGFRs. Despite concerns, the outcomes from small (≤ 5 years old) paediatric donors are similar compared to older paediatric donors. Careful selection of donor and recipient is warranted when using en-bloc kidneys from small DCD donors.

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