Survival of cadaveric renal transplant grafts from young donors and in young recipients

Abstract

Evidence from multicenter registries has suggested that cadaveric renal graft survival is poorer when either the recipient or the donor is very young. We therefore analyzed our results from a single pediatric center. There was a significant correlation between greater recipient age and improved cadaveric graft (P = 0.002) and patient (P = 0.0009) survival. The age of the donor also appeared important, particularly in very young children, but became less so as donor age rose. Forty-four percent of recipients under 3 years old who received cadaveric kidneys from donors less than 4 years old lost their grafts as a result of renal thrombosis, ischemia, or technical problems, compared with only 3% of recipients over 9 years of age, whose grafts came from donors who were also over 9 years. The 1-year first cadaveric graft survival rates for these two age groups were 33% and 82% respectively. Our experience confirms the poor findings reported in very young recipients and with very young donors.

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“…Reports of increased organ discard rates, technical complications, decreased functional nephron reserve, and claims of suboptimal patient and graft survival all have contributed to the reluctance to transplant kidneys from young donors. [2][3][4] In a comprehensive analysis of 203 transplants from donors younger than 5 years from The North American Pediatric Renal Trials and Collaborative Studies database, it was demonstrated that the risk of graft loss when using a neonatal donor was 2.7 times that of an ideal donor (age range, 20-25 years) 5 with 9.9% of grafts lost because of vascular thrombosis.…”

Transplanting Pediatric Deceased-Donor Kidneys Into Adult Recipients: An Iranian Experience

“…Some studies report poor transplant outcomes when the renal donor is young. 4,5 Other studies confirm that deceased-donor pediatric donor kidneys and adult donor kidneys give equivalent results when transplanted into adult recipients. 7,8 Previous studies that report poor outcomes from pediatric donors have rationalized their results on 2 reasons.…”

Renal Transplantation From Pediatric Donors in the United Kingdom

“…All of these reservations are surmountable. [11][12][13][14][15][16][17][18][19][20][21][22][23][24] The number of nephrons in each kidney (1.4-3.5 million) is finalized by 36 weeks of gestation. 25 After birth, the growth of the kidney is through hypertrophy determined to some extent the development of creatinine mass of the individual.…”