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Optimizing the utilization of kidneys from small pediatric deceased donors under 15 kg by choosing pediatric

Mingxing Sui1, Wenyu Zhao1, Yu Chen2

  • 1Organ Transplantation Center, Changhai Hospital, Second Military Medical University, Shanghai, China.

Pediatric Transplantation
|December 1, 2015
PubMed

Insights

Pediatric deceased donor kidneys, often discarded for adult transplants, show high success when given to pediatric recipients. This strategy improves graft utilization and survival rates in children needing kidney transplants.

Area of Science:

  • Nephrology
  • Transplantation Surgery
  • Pediatric Medicine

Background:

  • Pediatric deceased donor kidneys are frequently transplanted into adult recipients (PTA), leading to poor outcomes.
  • Weight mismatch in PTA transplants results in high graft discard rates and increased en bloc kidney transplants (EBKTs).

Purpose of the Study:

  • To optimize the utilization of scarce small pediatric donor kidneys.
  • To evaluate the feasibility and efficacy of allocating these kidneys to pediatric recipients (PTP).

Main Methods:

  • Retrospective analysis of kidneys from 27 infant donors (≤ 15 kg) transplanted into 38 pediatric recipients between February 2012 and October 2014.
  • Kidneys from donors weighing 2.5-5 kg were used for EBKT; kidneys from donors weighing 5-15 kg were used for single kidney transplants (SKT).

Main Results:

  • Achieved an overall utilization rate of 94.12% for small pediatric deceased donor kidneys.
  • Reported a graft survival rate of 89.47% after 3-26 months follow-up, with four losses due to vascular thrombosis.
  • Successfully performed 10 EBKTs and 28 SKTs.

Conclusions:

  • Allocating kidneys from low-body-weight deceased donors to pediatric recipients is a viable strategy.
  • Single kidney transplants using infant donor kidneys (≥ 5 kg) are feasible in experienced centers, optimizing graft utilization.

Keywords:
infant donorskidney transplantationpediatric

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