Clinical Observation of Single Kidney Transplantation for Adult Recipients from Non-Heartbeating Pediatric Donors

Abstract

Objective To investigate the early clinical effect of single kidney transplantation for adult recipients from non-heartbeating pediatric donors(<12y),comparing with single renal transplantation from adult kidney donor. Methods A retrospective review of clinical data of donors and recipients kidney transplantation from donation after deceased cardiac donors (DCD) performed from November 2013 to June 2017 in kidney transplantation department of the first affiliated hospital of Xi’an Jiaotong university. There were three groups divided by the long axis of the kidney:<6cm(8); 6-8cm(18); >8cm(30). Postoperative blood pressure, urinary protein, renal function of 50 recipients were monitored tightly. Results The long axis of the kidney before and after opening blood flow were 7.53±1.13cm and 8.48±1.10cm totally. Recipients’ blood pressure were held during 110/60 to 140/100mmHg and weight were 40-60kg. Respectively, renal function of there groups recovered(serum creatinine<177μmol/L) in 6.4±3.3, 10.6±2.4, 18.6±5.8 days. Disappearance of proteinuria were markedly correlated with control of postoperative blood pressure and donor renals size. Kidney volume increases significantly within one month after surgery and long axis of the kidney will be more than 10 cm after half a year. Conclusions Short-term out-comes of single kidney transplantation from pediatric donors seemed a little worse than adult donors. It mainly manifested in less urine, strict blood pressure control, long time proteinuria and more complications. So, we believe non-heartbeating pediatric donors is available resources, but recipients’ systolic pressure must be control about 120mmHg and proteinuria and renal function should be strict monitored, especially in the long axis of the kidney less than 6cm. It maybe relative to damage of the glomerular basement membrane. A further study is needed for the electron microscope. Key words: non-heartbeating pediatric donors; kidney transplantation; blood pressure; proteinuria