Kidney donation from children after cardiac death

Area of Science:

• Nephrology
• Transplantation immunology
• Pediatric surgery

Background:

• Pediatric kidney donation after cardiac death (DCD) is underutilized due to ethical concerns and limited outcome data.
• Expanding the donor pool is crucial for pediatric kidney transplantation.

Purpose of the Study:

• To report the Dutch experience with kidney transplantation using pediatric DCD donors.
• To evaluate the outcomes of kidney transplantation from pediatric DCD donors.

Main Methods:

• Observational cohort study of consecutive kidney transplantations from pediatric DCD donors (January 1995–July 2006).
• Data collected from the Dutch Organ Transplant Registry.
• Analysis of donor, graft, and recipient characteristics, including glomerular filtration rate, graft, and patient survival.

Main Results:

• Eighty-eight patients received 90 pediatric DCD kidneys, representing 31% of pediatric donor kidneys transplanted.
• Immediate graft function was 49%, delayed graft function 44%, and primary nonfunction 7%.
• Five-year overall graft and patient survival rates were 80% and 88%, respectively.

Conclusions:

• Kidneys from pediatric DCD donors are suitable for transplantation.
• Pediatric DCD kidney transplantation can substantially expand the donor pool with favorable outcomes.