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Increasing the donor pool using en bloc pediatric kidneys for transplant
Ana I Sánchez-Fructuoso1, Dolores Prats, Maria J Pérez-Contín
1Department of Nephrology, Hospital Clínico San Carlos, Facultad de Medicina, Universidad Complutense, Madrid, Spain. sanchezfruct@telefonica.net.
Transplantation
|October 28, 2003
Summary
En bloc pediatric kidney transplants (EBPKT) offer similar long-term graft survival to adult kidney transplants (AKT). EBPKT demonstrate superior graft function with fewer rejections, though vascular complications are a concern.
Area of Science:
- Nephrology
- Transplantation Surgery
- Pediatric Urology
Background:
- En bloc pediatric kidney transplantation (EBPKT) remains controversial.
- Comparison with single adult donor kidney transplantation is needed to assess long-term outcomes.
Purpose of the Study:
- To compare long-term graft survival and function between EBPKT and adult kidney transplants (AKT).
- To evaluate the safety and efficacy of EBPKT.
Main Methods:
- Retrospective review of 66 EBPKT recipients and 434 AKT recipients (1990-2002).
- Analysis of short- and long-term transplant outcomes and graft function quality.
- Demographic matching of recipient groups.
Main Results:
- Similar death-censored graft survival rates at 1 and 5 years (EBPKT: 83.3%/81.1%; AKT: 89.2%/84.6%).
- Improved graft function in EBPKT compared to AKT.
- Vascular thrombosis was the primary cause of graft loss in EBPKT; acute rejection was more frequent in AKT.
Conclusions:
- EBPKT achieves comparable graft survival to AKT.
- EBPKT offers excellent long-term graft function with a lower incidence of acute rejection.
- Vascular complications are the main risk factor for graft loss in EBPKT.