Related Experiment Videos
Influence of recipient and donor age in pediatric renal transplantation. Collaborative Transplant Study
1Institut für Immunologie der Universität, Heidelberg, Federal Republic of Germany.
Insights
Donor and recipient age significantly impact kidney transplant success. Kidneys from adult donors offer the best outcomes, even for young recipients, outperforming those from very young donors.
Area of Science:
- Nephrology
- Transplantation Immunology
- Pediatric Surgery
Background:
- First cadaver kidney transplants are crucial for pediatric end-stage renal disease.
- Understanding factors influencing graft survival is essential for optimizing transplant outcomes.
- Recipient and donor age are recognized demographic variables in transplantation.
Purpose of the Study:
- To analyze the impact of recipient and donor age on the outcome of first cadaver kidney transplants.
- To determine the relative importance of donor versus recipient age in graft survival.
- To evaluate graft survival rates based on specific age groups of recipients and donors.
Main Methods:
- Retrospective analysis of 1325 pediatric kidney transplant recipients.
- Inclusion of 4230 kidney transplants from pediatric donors.
- Statistical analysis to assess the significance of recipient and donor age on graft survival.
Main Results:
- Graft survival significantly improved with increasing recipient age (P < 0.0001).
- Graft survival significantly improved with increasing donor age (P < 0.0001).
- Donor age demonstrated an overriding effect on graft outcome; kidneys from donors <3 years old had poor results, while adult donor kidneys yielded the best outcomes, even in young recipients.
Conclusions:
- Donor age is a critical determinant of kidney transplant success, more so than recipient age.
- Utilizing kidneys from adult donors is recommended for optimal graft survival, irrespective of recipient age.
- Kidney transplantation from adult donors demonstrates high 1-year graft survival rates across various pediatric and adult recipient age groups.
Abstract:
The influence of recipient and donor age on the outcome of first cadaver kidney transplants was analyzed in a series of 1325 pediatric recipients and in 4230 transplants from pediatric kidney donors. Graft survival improved significantly with increasing recipient age (P less than 0.0001) and donor age (P less than 0.0001). Combined analysis of recipient and donor age groups revealed an overriding effect of donor age on graft outcome. Kidneys from donors younger than 3 years old consistently yielded poor results regardless of recipient age. Kidneys from adult donors gave the best results even in young recipients 0-5 years of age. With adult donor kidneys in cyclosporin-treated patients, high 1-year graft survival rates of 86 +/- 9% (SE) in 15 0- to 5-year-old recipients, 85 +/- 3% in 137 6- to 12-year-old recipients, and 83 +/- 1% in 6027 13- to 40-year-old recipients were observed.