Transplantation of Pediatric en Bloc Cadaver Kidneys Into Adult Recipients1

Abstract

Collectively, these data indicate that transplanting pediatric en bloc kidneys into adult recipients results in equivalent patient and graft survival compared with adult cadaveric kidneys. Further, the data also suggest that pediatric en bloc kidneys need not be strictly allocated based on recipient weight or age criteria.

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“…A delayed graft function was reported in 15% of recipients of EBK, which was not statistically different from control group results. 7 A study with of pediatric EBK 22-year follow-up from Austria found creatinine levels of 1.08 mg/dL at 2 years after transplant. 15 Tables 2 and 3 summarizes the major dual kidney transplant studies and the graft survival graft function.…”

“…Conjoint ureters were anas tomosed to the bladder using extravesical techniques. 7 Newcastle team described a modification for EBK. One of the main concerns of the original technique was torsion of the whole block or 1 kidney at risk for thrombosis due to a long vascular pedicle.…”

“…6 Two decades earlier, dual kidneys from pediatric donors had been transplanted into adults. 7 Currently, centers perform DKTs using different organ selection criteria and techniques. Although no randomized prospective studies comparing the results of DKT to single transplant have been published, several authors have reported acceptable results even with kidneys considered unacceptable by others.…”

“…To support this approach, Andres and associates performed DKTs in recipients with mean age of 60 ± 5 years old from donors with mean age 75 ± 7 years. 11 Hobart and associates failed to show a difference in recipient or graft survival to support using age or weight as variables to guide selection in his 33 pediatric EBK into adult recipients, 7 although it has been suggested that candidates of pediatric EBK should weigh less than 80 kg. 15 In general, DKT is offered to patients 60 years or older.…”

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

“…They have also reported that graft survival and/or renal function from dual kidney transplants is better than that from single marginal donor kidneys (34,37,38). Transplantation of two pediatric kidneys into adult recipients has also been associated with patient and graft survivals comparable to those of single cadaveric transplants from adult donors (40).…”