PURPOSE: The use of small pediatric kidneys obtained from very young donors after cardiac death (DCD) has been limited and this remains an underutilized organ source.
MATERIALS AND METHODS: We reviewed all renal transplants at our institution from 2000 to 2013 to identify recipients of an en-bloc pair of kidneys from pediatric donors less than 4 years of age. The outcomes of DCD en-bloc allografts were compared with neurologic determination of death (NDD) en-bloc allografts.
RESULTS: 21 recipients of en bloc renal allografts were identified of which 4 organ pairs were obtained through DCD. The mean donor age was 20.6 ± 11.6 months and mean donor weight was 12.4 ± 3.7 kg. Delayed graft function (DGF) occurred in 2/4 DCD and 3/17 NDD en bloc recipients. At one year post-transplantation, mean glomerular filtration rates (GFRs) were similar at 80.7 ± 15.3 versus 85.7 ± 33.4 mL/min/1.73 m2 in the DCD and NDD groups respectively (p = NS). Surgical complications occurred in three patients; no grafts were lost to thrombosis.
CONCLUSIONS: We are encouraged to report successful transplantation of a small cohort of DCD pediatric en-bloc kidneys from donors less than 4 years of age. Outcomes at one year are comparable to NDD en bloc allograft recipients.
Written by:
Dion M, Rowe N, Shum J, Weernink C, Felbel S, McAlister VC, Sener A, Luke PP. Are you the author?
Department of Surgery, Division of Urology, Western University, London, Ontario, Canada; Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada; Department of General Surgery, Western University, London, Ontario, Canada; Department of Surgery, Division of Urology, Western University, London, Ontario, Canada.
Reference: J Urol. 2014 Jul 24. pii: S0022-5347(14)04038-5.
doi: 10.1016/j.juro.2014.07.089
PubMed Abstract
PMID: 25066870
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