Long‐term outcomes of single paediatric vs. ideal adult renal allograft transplants in adult recipients

Csapó, Zsolt; Knight, Richard J.; Podder, Hemangshu; Kerman, Ronald H.; Schoenberg, L.; Katz, Stephen M.; Buren, Charles T. Van; Kahan, Barry D.

doi:10.1111/j.1399-0012.2006.00500.x

Cited by 13 publications

(11 citation statements)

References 18 publications

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“…Recent reports have shown that the graft survival rate for en bloc kidney transplantation (EBKT) is comparable to either adult deceased donor kidney transplantation (DDKT) or living donor kidney transplantation (LDKT) . Pediatric kidneys transplanted en bloc into adults grow to normal adult renal size within the first few months after transplantation and exhibit a longitudinal increase in glomerular filtration rate (GFR) for as many as 5 years after transplantation . However, while EBKT may mitigate technical risk in the short term and functional risk in the long term, transplantation of two young and healthy kidneys into a single patient is resource intensive and fails to maximize transplant opportunities.…”

Section: Introductionmentioning

confidence: 99%

Optimizing Recovery, Utilization and Transplantation Outcomes for Kidneys From Small, ≤20 kg, Pediatric Donors

Maluf

Carrico²,

Rosendale³

et al. 2013

American Journal of Transplantation

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The optimal balance between maximizing the number versus the outcome of transplantation utilizing kidneys from small (≤20 kg) pediatric donors remains unclear, complicated by the choice of single versus en bloc transplantation with their attendant technical risks. Using the Organ Procurement and Transplantation Network (OPTN) database, we examined kidney recovery and utilization patterns, and 1‐year transplant outcomes by single kilogram weight strata. Between January 1, 2005 and June 30, 2010, 2352 kidneys from ≤20 kg donors were transplanted into 1531 recipients, 710 single kidney transplants (SKTs) and 821 en bloc kidney transplants (EBKTs). Increased donor weight was associated with higher rates of recovery, transplantation and SKT. Low donor weight (linear p < 0.001; quadratic p = 0.003), SKT versus EBKT (p = 0.008), increased cold ischemia time (p = 0.003), local versus nonlocal donor (p = 0.0044), low versus high volume center (p = 0.003) and the interaction term between center volume and donor weight (p = 0.0024) were associated with graft failure. Notably, lower donor weight exacerbated the negative impact of low center volume but did not worsen the negative impact of SKT on outcomes. Our data show that EBKT offers superior 1‐year survival at the expense of accomplishing one rather than two transplants. However, SKTs yield excellent outcomes when performed at experienced centers.

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Section: Introductionmentioning

confidence: 99%

Optimizing Recovery, Utilization and Transplantation Outcomes for Kidneys From Small, ≤20 kg, Pediatric Donors

Maluf

Carrico²,

Rosendale³

et al. 2013

American Journal of Transplantation

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“…Transplantation of kidneys from pediatric donors into adult recipients is a well‐established technique with successful outcomes, even from very small donors . In recent years, the technical feasibility of pancreas transplantation from pediatric donors has also been demonstrated .…”

Section: Discussionmentioning

confidence: 99%

Simultaneous en-bloc pancreas and kidney transplantation from a small pediatric donor after circulatory death

Dobbs

Shapey

Summers

et al. 2019

American Journal of Transplantation

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Simultaneous pancreas and kidney transplantation (SPKT) is an effective treatment option for patients with type 1 diabetes and end stage renal disease. Increasing demands for organs for transplantation coupled with a rise in age and size of adult donors has led to greater utilization of pediatric donors, and with good outcomes. Nonetheless, there remains reticence among transplant surgeons to transplant pancreases from small pediatric donors despite the optimal characteristics and macroscopic features of the younger pancreas. We report a successful case of SPKT from a small pediatric donor and explore the aspects of potential concern that might have led some clinicians to decline these organs. We also discuss the measures taken to overcome potential obstacles to successful transplantation from this donor source, and the rationale behind them.

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“…[1] Similarly, Csapo et al , have published similar recipient outcomes when comparing ideal adult vs. pediatric donors. [2] Ahn et al , have recommended that in the present era of modern antiviral agents, such as lamivudine, renal transplantation in HbsAg-positive ESRD patients should not abandoned. [3] Veruox et al , have also recommended that kidneys from HbsAg-positive donors can be safely transplanted to HbsAg-seropositive recipients.…”

Section: Discussionmentioning

confidence: 99%

Partial siamese twin as potential organ donor

Kapoor¹,

Maheshwari²,

Srivastava³

et al. 2010

Indian J Urol

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During evaluation of a partial Siamese twin for removal of nonviable parasitic part in an 8-year-old male child, a fully functional kidney was found. The functional status of the extra kidney was found to be within acceptable limits for the purpose of transplant, which was subsequently done in a 24-year-old patient with end-stage renal disease. The recipient is healthy 19 months after the surgery. The possibility of using organs from a partial Siamese twin makes this a unique case report.

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Long‐term outcomes of single paediatric vs. ideal adult renal allograft transplants in adult recipients

Abstract: Transplantation of single paediatric donor kidneys into low BMI adult recipients provided equivalent outcomes to those of grafts from adult donors between the ages of 18 and 45 yr.

Cited by 13 publications

References 18 publications

Optimizing Recovery, Utilization and Transplantation Outcomes for Kidneys From Small, ≤20 kg, Pediatric Donors

Optimizing Recovery, Utilization and Transplantation Outcomes for Kidneys From Small, ≤20 kg, Pediatric Donors

Simultaneous en-bloc pancreas and kidney transplantation from a small pediatric donor after circulatory death

Partial siamese twin as potential organ donor

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