Intermediate-term outcome of single kidney grafts from pediatric donors weighing 10-14 kg in adult recipients.

Abstract

BACKGROUND:

Kidneys from pediatric donors weighing <10 kg are preferably transplanted en bloc, while kidneys from donors weighing >15 kg can be safely transplanted as single kidneys. However, single kidney transplantation from donors weighing 10-14 kg is controversial and has not been well investigated.

METHODS:

We analyzed the outcome of 15 recipients of single kidneys from donors weighing 10-14 kg (study group) with 40 recipients receiving an allograft from ideal deceased donors (control group).

RESULTS:

After a follow-up of three yr, death-censored graft survival was 100% in both groups. The calculated creatinine clearance was lower in the study group at six months (53 vs. 71 mL/min; p = 0.01) and similar at 12 months (68 vs. 68 mL/min; p = 0.48), 24 months (81 vs. 70 mL/min; p = 0.58), and 36 months (74 vs. 69 mL/min; p = 0.59). Urinary albumin/creatinine ratios were comparable between the two groups up to two yr. At three yr, urinary albumin/creatinine ratios were higher in the study group than the control group (10.5 vs. 0.9 mg/mmol; p = 0.007). Surveillance biopsies at three and six months post-transplant revealed no evidence for focal segmental glomerulosclerosis in the study group.

CONCLUSIONS:

Transplantation of single pediatric kidneys from donors weighing 10-14 kg into adult recipients provides excellent intermediate-term outcomes. Low-grade albuminuria, three yr post-transplant, might indicate late-onset hyperfiltration injury.

• Authors: Isabel Gröschl, Thomas Wolff, Lorenz Gürke, Thomas Eugster, Helmut Hopfer, Jürg Steiger, Stefan Schaub, Felix Burkhalter
• Journal: Clinical transplantation (Clin Transplant) 2013 May-Jun Vol. 27 Issue 3 Pg. E302-7 ISSN: 1399-0012 [Electronic] Denmark
• PMID: 23528134 (Publication Type: Comparative Study, Journal Article)
• Copyright: © 2013 John Wiley & Sons A/S.

Topics

• Adolescent
• Adult
• Aged
• Case-Control Studies
• Child, Preschool
• Female
• Follow-Up Studies
• Glomerular Filtration Rate
• Glomerulosclerosis, Focal Segmental (diagnosis, etiology)
• Humans
• Infant
• Kidney Diseases (complications, mortality, surgery)
• Kidney Transplantation
• Male
• Middle Aged
• Postoperative Complications
• Prognosis
• Retrospective Studies
• Risk Factors
• Survival Rate
• Young Adult