[Kidneys from donors less than 5 years of age for transplantation: how to use them?]

We evaluated the results of 27 renal transplants (RT) from donors less than 5 years of age (mean 2.1 +/- 1.1 years). Seven were transplanted en bloc and the rest separately. Fourteen recipients were children and 13 were adults. The overall graft survival at one year was 51%. Kidneys from donors less than 2 years of age that had not been transplanted en bloc had a survival rate of 21%. There was a marked improvement in the one-year graft survival (71%) for kidneys from donors under 2 years of age that had been transplanted en bloc, and a slight improvement (53%) for those from donors over 2 years of age. No urological complications were observed. Five RT were lost due to vascular complications. Good renal graft function was observed in both children (mean plasma creatinine 1.65 mg/dl.) and adults (mean plasma creatinine 1.90 mg/dl.). The one-year graft survival rate was 59% for the adult recipients and 42% for the children. We can conclude from these findings that kidneys from pediatric donors can be transplanted to children as well as adults and should probably be performed en bloc when the donor is less than 2 years of age.