One-Year Follow-up of En Bloc Renal Transplants from Pediatric Donors in Adult Recipients

Abstract

Objectives The optimal use of kidneys from small pediatric cadaveric donors remains controversial. The aim of this study was to analyze short-term graft and patient survivals of en bloc kidney transplantations compared with single cadaveric adult donor kidney transplantations. Patients and methods We compared the 1-year evolution of 14 adult recipients of en bloc pediatric kidney donors (EBKT) of median age 13.5 ± 14.5 months (range = 3 days to 48 months) with 182 recipients of ideal adult cadaveric donors (ADT) showing a median age of 30 ± 21 years (range = 14–45 years). Results Besides the different age and weight of the donors, EBKT recipients were more commonly women ( P = .05) and received thymoglobulin induction treatment ( P = .00). Delayed graft function was higher in EBKT (46.2% vs 22.2%, P = .05), with no differences in the incidences of acute rejection episodes. Mean serum creatinine values at 3, 6, and 12 months after transplantation were 1.1 ± 0.3, 1.1 ± 0.2, and 1.0 ± 0.2 mg/dL in the EBKT group, compared with 1.3 ± 0.5 ( P = .16), 1.3 ± 0.5 ( P = .02), and 1.3 ± 0.6 ( P < .01) in the ADT group. Vascular allograft complications were more frequent among EBKT. Graft survival rate at 1 year was 92% in both groups, with no differences in patient survival (100% in EBKT vs 92% in ADT; P = .49). Conclusions EBKT from small pediatric donors show excellent graft function and 1-year survival and should be considered for transplantation into adults.