Single kidney transplantation from pediatric donors after citizens death to adult recipients

Abstract

Objective To investigate the feasibility and safety of the single kidney transplantation from pediatric donors to adult recipients. Methods From May 2013 to January 2017, a total of 50 single kidney transplants from pediatric donation after citizen death (DCD) donors of age between 3 to 12 years to adult recipients were performed and the data were summarized. Results The average age of donors was 6.4±2.5 years with an average donor weight of 19.1±5.9 kg, and the average kidney length was 6.3±0.6 cm. For the 50 adult recipients, the average age was 38.5±12.1 years, the average body weight was 56.1±13.1 kg, and the number of female patients was 26 (52%). All except 3 of these patients were transplanted for the first time. Delayed graft function (DGF) was observed in 15 patients (30%). The average value of eGFR among all the patients was rapidly increased in the first 3 months after transplantation and then steadily increased to (82.3±13.4) mL·min-1·1.73 m-2 at 1st year, followed by (83.8±22.5) mL·min-1·1.73 m-2 at 2nd year. Four renal grafts developed acute rejection (8%), and 3 of them were successfully reversed by the treatment. Pulmonary infection occurred in 4 recipients, and 2 died. During a follow-up period of 19 months, uncensored grafts survival was 94%, and patients survival was 96%. Conclusion Excellent intermediate-term transplant outcome can be achieved by using single kidneys from pediatric donors elder than 3 years, which may shorten the waiting time in adult recipients and alleviate the contradictions in the absence of suitable pediatric recipients. Key words: Child; Donors; Kidney transplantation; Graft survival