Pediatric En Bloc Kidney Transplantation:Comparable Outcomes to Standard Criteria Deceased and Living Donor Kidney Transplantation in Adult Recipients.

Abstract

Background: Kidney transplantation from very young pediatric donors has traditionally been associated with poor outcomes due to risk of technical complications. We present our experience with pediatric en bloc kidney transplantation (EBKT) from donors aged less than 2-years and compare outcomes to standard deceased (SCD) and living donor kidney transplantation (LDKT). Methods: A retrospective data analysis of 440 renal transplants performed at our institute between 2004 to 2012 was done. Non-heart beating donors, expanded criteria donors, pediatric kidneys transplanted singly and recipients with Hepatitis C or HIV were excluded. Univariate variables were compared using t-test for continuous and chi-square test for categorical variables. Kaplan-Meier patient and graft survival curves were compared using log-rank test. Results: Mean donor age for pediatric donors was 18 months and mean weight was 10 kgs. Donor and recipient characteristics with outcome comparisons are shown in table.Table: No Caption available.Conclusions: En bloc transplantation of pediatric kidneys in to adult recipients provides patient and graft outcomes that are comparable (at 3-years) to standard criteria deceased and living donor kidney transplantation. EBKT from donors aged less than 2 years old and weighing less than 10 kg is a viable option that can increase the utilization of organs that would otherwise be discarded.