Expanding the Envelope: Favorable Outcomes Utilizing Kidneys From Small Pediatric Donors (≤ 15 kg).
BACKGROUND: Utilization of kidneys from small pediatric donors (SPDs ≤ 15 kg) is limited. Decisions to split and use the kidneys for 2 recipients remain controversial.
METHODS: Retrospective single-center study aimed primarily at evaluating graft loss within 30 days after transplant using SPD kidneys. Recipients were divided into group A (donor weight < 10 kg, n = 24) and group B (≥ 10 kg, n = 16).
RESULTS: Forty transplants were performed with 100% patient survival. Mean follow-up was 402 days, overall graft survival was 95%, with 91.7% and 100% in groups A and B, respectively (P = .24). Mean recipient-to-donor weight ratio (RTDWR) was higher in group A (10.5 vs 6.3, P < .001). Surgical complications were similar between the groups. These were more common with en bloc compared to single implantation (P = .05), and RTDWR was the main predictor (P = .005). Graft function was similar between the groups; mean 12-month creatinine was 1.2 mg % and eGFR was 58.2 mL/min/1.73 m
CONCLUSION: Utilization and early splitting of SPD kidneys yields favorable graft survival and function irrespective of donor weight and age. Early splitting should be considered.
Published In/Presented At
Fayek, S. A., Ali, M. S., Hasham, L., Herbert, M., Allam, S. R., & Rofaiel, G. (2018). Expanding the Envelope: Favorable Outcomes Utilizing Kidneys From Small Pediatric Donors (≤ 15 kg). Transplantation proceedings, 50(10), 3204–3210. https://doi.org/10.1016/j.transproceed.2018.04.037
Medicine and Health Sciences
Department of Surgery