Expanding the Envelope: Favorable Outcomes Utilizing Kidneys From Small Pediatric Donors (≤ 15 kg).
Transplant Proc
; 50(10): 3204-3210, 2018 Dec.
Article
in En
| MEDLINE
| ID: mdl-30577186
ABSTRACT
BACKGROUND:
Utilization of kidneys from small pediatric donors (SPDs ≤ 15 kg) is limited. Decisions to split and use the kidneys for 2 recipients remain controversial.METHODS:
Retrospective single-center study aimed primarily at evaluating graft loss within 30 days after transplant using SPD kidneys. Recipients were divided into group A (donor weight < 10 kg, n = 24) and group B (≥ 10 kg, n = 16).RESULTS:
Forty transplants were performed with 100% patient survival. Mean follow-up was 402 days, overall graft survival was 95%, with 91.7% and 100% in groups A and B, respectively (P = .24). Mean recipient-to-donor weight ratio (RTDWR) was higher in group A (10.5 vs 6.3, P < .001). Surgical complications were similar between the groups. These were more common with en bloc compared to single implantation (P = .05), and RTDWR was the main predictor (P = .005). Graft function was similar between the groups; mean 12-month creatinine was 1.2 mg % and eGFR was 58.2 mL/min/1.73 m2. Sixteen out of 38 patients developed proteinuria (42%) with no difference among subgroups, although male recipients were at a higher risk (OR = 8.4 [95% CI 1.5-46.1], P = .014); 83% responded to therapy.CONCLUSION:
Utilization and early splitting of SPD kidneys yields favorable graft survival and function irrespective of donor weight and age. Early splitting should be considered.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tissue Donors
/
Kidney Transplantation
/
Transplants
/
Graft Survival
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Middle aged
Language:
En
Journal:
Transplant Proc
Year:
2018
Document type:
Article