Single versus en bloc kidney transplant from donors less than or equal to 15 kg to pediatric recipients

Pediatr Transplant. 2021 Mar;25(2):e13719. doi: 10.1111/petr.13719. Epub 2020 May 6.

Abstract

With small kidneys, EBKTs could provide sufficient renal mass but could lead to inefficient use of resources, while SKTs could result in insufficient function due to small renal mass. We aimed to compare the outcomes of EBKT and SKT from small donors weighing ≤15 kg to pediatric recipients. We retrospectively reviewed all pediatric patients who met the inclusion criteria between January 1, 1984, and April 30, 2019, at a single institution. Of a total of 23 patients, 12 received EBKT and 11 received SKT. The median age of donors, weight of donors, and weight of recipients were comparable between the two groups. The median age of recipients and median weight of allografts were greater in the EBKT group than in the SKT group. The median follow-up was 53.9 months. There was no significant difference in eGFR, protein creatinine ratios at 1-year follow-up, and overall graft survival. The size of the kidney increased by approximately 13%-43% in the EBKT group and 40%-60% in the SKT group. This study demonstrated that kidneys from small donors weighing 5-15 kg could be split in pediatric recipients without compromising the outcome.

Keywords: en bloc; kidney transplantation; pediatrics.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Body Weight*
  • Child
  • Child, Preschool
  • Donor Selection / methods*
  • Female
  • Follow-Up Studies
  • Graft Survival
  • Humans
  • Infant
  • Infant, Newborn
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / methods*
  • Male
  • Retrospective Studies
  • Tissue Donors
  • Treatment Outcome