Kidney transplantation outcomes for adult recipients of pediatric donor kidneys.
Adolescent
Adult
Age Factors
Child
Child, Preschool
Donor Selection
/ methods
Female
Follow-Up Studies
Graft Survival
Humans
Infant
Infant, Newborn
Kidney Transplantation
/ mortality
Male
Middle Aged
Multivariate Analysis
Outcome Assessment, Health Care
Registries
Survival Analysis
Tissue Donors
Young Adult
donor registries
kidney clinical
pediatric donors
post-transplant outcomes
Journal
Pediatric transplantation
ISSN: 1399-3046
Titre abrégé: Pediatr Transplant
Pays: Denmark
ID NLM: 9802574
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
received:
04
02
2020
revised:
23
04
2020
accepted:
26
05
2020
pubmed:
15
6
2020
medline:
5
1
2022
entrez:
15
6
2020
Statut:
ppublish
Résumé
Despite a paucity of data assessing transplantation of deceased-donor pediatric donor kidneys into adult recipients, utilization of pediatric organs is declining in the UK, likely due to concerns that such organs may have inferior outcomes. However, we hypothesized that these concerns may be unfounded. As such, the aim of the study was to compare kidney transplant outcomes between adult recipients of pediatric and adult deceased-donor organs. Data were collected from the UK Transplant Registry for all adult (18+ years) deceased-donor single-kidney transplant recipients between January 2000 and January 2016. Univariable and multivariable analyses were undertaken, to compare a range of outcomes between recipients of kidneys from pediatric and adult donors. Transplants were stratified by the donor age (years) as follows: 0-16 (n = 666), 17-18 (n = 465), and 19-44 (n = 7378). Recipients of pediatric donor kidneys were observed to have improved long-term graft function, with a median creatinine at 1 year of 109 vs. 117 μmol/L for recipients of donors aged 0-16 vs. 19-44 years (P < .001). However, on multivariable analysis, this was not found to correspond to a significant difference in patient (P = .914) or graft survival (P = .190) between the donor age groups. Subgroup analysis within the younger donors found no significant differences in recipient outcomes between donors aged 0-6, 7-12, and 13-16 years. In this population cohort study, we identified excellent outcomes among adult recipients of pediatric donor kidneys. Pediatric donors are a valuable source of organs for adult recipients in an era where organ demand is rising.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13767Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
Gourlay W, Stothers L, McLoughlin MG, Manson AD, Keown P. Transplantation of pediatric cadaver kidneys into adult recipients. J Urol. 1995;153(2):322-325.
Csapo Z, Knight RJ, Podder H, et al. Transplantation of single pediatric kidneys into adult recipients. Transplant Proc. 2005;37(2):697-698.
Daar AS, Al Lawati NM. The world's youngest cadaveric kidney transplant: medical, surgical and ethical issues. Transplant Direct. 2016;2(12):e117.
Cheng K, Ye Q, Ming Y, et al. Impact and application of donor/recipient body surface area on kidney transplantation from pediatric donor to adult recipient. Transplant Proc. 2016;48(10):3274-3278.
Modlin C, Novick AC, Goormastic M, Hodge E, Mastrioanni B, Myles J. Long-term results with single pediatric donor kidney transplants in adult recipients. J Urol. 1996;156(3):890-895.
Schreuder MF. Safety in glomerular numbers. Pediatr Nephrol. 2012;27(10):1881-1887.
Balachandran VP, Aull MJ, Goris M, Figueiro J, Leeser DB, Kapur S. Successful transplantation of single kidneys from pediatric donors weighing less than or equal to 10 kg into standard weight adult recipients. Transplantation. 2010;90(5):518-522.
Johnson RJ, Armstrong S, Belger MA, et al. The outcome of pediatric cadaveric renal transplantation in the UK and Eire. Pediatr Transplant. 2002;6(5):367-377.
Dave RV, Hakeem AR, Dawrant MJ, et al. Renal transplantation from pediatric donors in the United Kingdom. Transplantation. 2015;99(9):1968-1975.
Miller AJ, Kiberd BA, Alwayn IP, Odutayo A, Tennankore KK. Donor-recipient weight and sex mismatch and the risk of graft loss in renal transplantation. Clin J Am Soc Nephrol. 2017;12(4):669-676.
Adamusiak AM, Stojanovic J, Shaw O, et al. Desensitization protocol enabling pediatric crossmatch-positive renal transplantation: successful HLA-antibody-incompatible renal transplantation of two highly sensitized children. Pediatr Nephrol. 2017;32(2):359-364.
Abramowicz D, Oberbauer R, Heemann U, et al. Recent advances in kidney transplantation: a viewpoint from the Descartes advisory board. Nephrol Dial Transplant. 2018;33(10):1699-1707.
Arshad A, Hodson J, Chappelow I, et al. The impact of donor body mass index on outcomes after deceased kidney transplantation - a national population-cohort study. Transpl Int. 2018;31(10):1099-1109.
Arshad A, Hodson J, Chappelow I, Nath J, Sharif A. The influence of donor to recipient size matching on kidney transplant outcomes. Transplant Direct. 2018;4(10):e391.
Foss A, Line PD, Brabrand K, Midtvedt K, Hartmann A. A prospective study on size and function of paediatric kidneys (<10 years) transplanted to adults. Nephrol Dial Transplant. 2007;22(6):1738-1742.
Zhang R, Paramesh A, Florman S, et al. Long-term outcome of adults who undergo transplantation with single pediatric kidneys: how young is too young? Clin J Am Soc Nephrol. 2009;4(9):1500-1506.
Yagisawa T, Kam I, Chan L, Springer JW, Dunn S. Limitations of pediatric donor kidneys for transplantation. Clin Transplant. 1998;12(6):557-562.
Borboroglu PG, Foster CE 3rd, Philosophe B, et al. Solitary renal allografts from pediatric cadaver donors less than 2 years of age transplanted into adult recipients. Transplantation. 2004;77(5):698-702.
Maluf DG, Carrico RJ, Rosendale JD, Perez RV, Feng S. Optimizing recovery, utilization and transplantation outcomes for kidneys from small, </=20 kg, pediatric donors. Am J Transplant. 2013;13(10):2703-2712.
Samuel SM, Tonelli MA, Foster BJ, et al. Survival in pediatric dialysis and transplant patients. Clin J Am Soc Nephrol. 2011;6(5):1094-1099.
Hobart MG, Modlin CS, Kapoor A, et al. Transplantation of pediatric en bloc cadaver kidneys into adult recipients. Transplantation. 1998;66(12):1689-1694.
Damji S, Callaghan CJ, Loukopoulos I, et al. Utilisation of small paediatric donor kidneys for transplantation. Pediatr Nephrol. 2018;34(10):1717-1726.