En bloc kidney transplantation from pediatric donors: Comparable outcomes with living donor kidney transplantation

Amit Sharma, Robert A. Fisher, Adrian H. Cotterell, Anne L. King, Daniel Maluf, Marc P. Posner

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Background. En bloc kidneys from pediatric donors have been considered suboptimal for transplantation to adult recipients and their outcomes have rarely been compared with living donor kidney transplantation (LDKT). Traditionally, there has been hesitancy in transplanting en bloc kidneys from donors weighing less than 10 kg due to high risk of technical complications. Methods. Retrospective chart reviews were performed to compare outcomes after pediatric en bloc (n=20, mean donor weight 11.4 kg), standard criteria deceased (n=249), and living donor (n=215) kidney transplantation in adult recipients at our center. The outcomes after en bloc transplantation from young donors weighing less than or equal to 10 kg were compared with those from 11 to 15 kg donors. Results. The 5-year graft survival after en bloc, standard deceased, and LDKT were 92%, 70%, and 88%, respectively (P=ns). There were no vascular complications, and urine leak was seen in 1 of 20 en bloc transplants. The 1-year serum creatinine of 1.1±0.2 mg/dL in recipients from less than or equal to 10 kg donors was comparable with 0.9±0.5 mg/dL in 11 to 15 kg group (P=ns). Conclusions. Excellent long-term outcome after pediatric en bloc kidney transplantation from donors weighing less than or equal to 15 kg are comparable with those after LDKT. By using meticulous surgical technique and judicious recipient selection criteria, technical graft losses can be minimized when using en bloc pediatric kidneys from donors weighing less than or equal to 10 kg. Use of pediatric en bloc kidneys should be encouraged continuously to address the problem of organ shortage.

Original languageEnglish (US)
Pages (from-to)564-569
Number of pages6
JournalTransplantation
Volume92
Issue number5
DOIs
StatePublished - Sep 15 2011

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Living Donors
Kidney Transplantation
Tissue Donors
Pediatrics
Kidney
Transplantation
Transplants
Graft Survival
Patient Selection
Blood Vessels
Creatinine
Urine
Weights and Measures
Serum

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

En bloc kidney transplantation from pediatric donors : Comparable outcomes with living donor kidney transplantation. / Sharma, Amit; Fisher, Robert A.; Cotterell, Adrian H.; King, Anne L.; Maluf, Daniel; Posner, Marc P.

In: Transplantation, Vol. 92, No. 5, 15.09.2011, p. 564-569.

Research output: Contribution to journalArticle

Sharma, Amit ; Fisher, Robert A. ; Cotterell, Adrian H. ; King, Anne L. ; Maluf, Daniel ; Posner, Marc P. / En bloc kidney transplantation from pediatric donors : Comparable outcomes with living donor kidney transplantation. In: Transplantation. 2011 ; Vol. 92, No. 5. pp. 564-569.
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N2 - Background. En bloc kidneys from pediatric donors have been considered suboptimal for transplantation to adult recipients and their outcomes have rarely been compared with living donor kidney transplantation (LDKT). Traditionally, there has been hesitancy in transplanting en bloc kidneys from donors weighing less than 10 kg due to high risk of technical complications. Methods. Retrospective chart reviews were performed to compare outcomes after pediatric en bloc (n=20, mean donor weight 11.4 kg), standard criteria deceased (n=249), and living donor (n=215) kidney transplantation in adult recipients at our center. The outcomes after en bloc transplantation from young donors weighing less than or equal to 10 kg were compared with those from 11 to 15 kg donors. Results. The 5-year graft survival after en bloc, standard deceased, and LDKT were 92%, 70%, and 88%, respectively (P=ns). There were no vascular complications, and urine leak was seen in 1 of 20 en bloc transplants. The 1-year serum creatinine of 1.1±0.2 mg/dL in recipients from less than or equal to 10 kg donors was comparable with 0.9±0.5 mg/dL in 11 to 15 kg group (P=ns). Conclusions. Excellent long-term outcome after pediatric en bloc kidney transplantation from donors weighing less than or equal to 15 kg are comparable with those after LDKT. By using meticulous surgical technique and judicious recipient selection criteria, technical graft losses can be minimized when using en bloc pediatric kidneys from donors weighing less than or equal to 10 kg. Use of pediatric en bloc kidneys should be encouraged continuously to address the problem of organ shortage.

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