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  • Title: Outcome of single pediatric deceased donor renal transplantation to adult kidney transplant recipients.
    Author: Friedersdorff F, Fuller TF, Werthemann P, Cash H.
    Journal: Urol Int; 2014; 92(3):323-7. PubMed ID: 24281008.
    Abstract:
    INTRODUCTION: In times of organ shortage more kidneys were transplanted in 'expanded criteria kidney' programs. This study examines the outcome of adult kidney recipients from pediatric donors. MATERIALS AND METHODS: This single-center retrospective analysis evaluated eight adult patients who received a kidney from a deceased pediatric donor (age 5-17) between 06/2000 and 09/2011. RESULTS: The median donor age was 14 years (range 5-17). The median recipient age was 49 years (range 25-57). The median cold ischemia time was 13.3 h (range 4.3-20.1), while the median warm ischemia time was 53 min (range 42-60). The median follow-up was 35.8 months (range 7-142). Acute rejection was observed in 50.0% of cases. The median HLA mismatch was 2.0. The median 1-year creatinine level was 0.95 mg/dl, the uncensored 1-year graft survival was 75.0% and the 3-year graft survival 62.5%, respectively. No recipient died within the follow-up period. As severe surgical complications, one stenosis of the renal artery and one lymphocele needing surgical revision were observed. CONCLUSIONS: Renal transplantation of a deceased single pediatric donor to an adult recipient can be performed safely and shows a good outcome. Wherever feasible, single pediatric kidney transplantation can double the number of recipients over an 'en-bloc' transplantation. The price for a single pediatric kidney transplant may be a higher vascular complication rate and a higher rejection risk. Despite the higher risks, transplantation of a single pediatric donor kidney should be performed when accomplishable.
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