Long-term outcome of adults who undergo transplantation with single pediatric kidneys: how young is too young?

Clin J Am Soc Nephrol. 2009 Sep;4(9):1500-6. doi: 10.2215/CJN.04610908. Epub 2009 Aug 20.


Background and objectives: The optimal donor age for transplanting a single pediatric kidney in an adult recipient remains unknown. En block kidney transplantation is usually performed when the donor age is <5 yr.

Design, setting, participants, & measurements: We compared the outcomes of adult patients who underwent transplantation with single pediatric kidneys from donors who were younger than 5 yr (group 1, n = 40) and from donors who were aged 5 to 10 yr of age (group 2, n = 39) in our center.

Results: The donor kidney sizes were significantly smaller in group 1 than in group 2 (P < 0.001), and group 1 required more ureteral stents than group 2 (73 versus 38%). The surgical complications, delayed graft function, and development of proteinuria were similar in both groups. Group 1 had slightly higher rejection episodes than group 2 (25 versus 18%; P = 0.67), and graft function was comparable in both groups. There were no statistical differences between the two groups in patient (P = 0.73) or death-censored graft (P = 0.68) survivals over 5 yr.

Conclusions: Single pediatric kidney transplants from donors who are younger than 5 yr can be used with acceptable complications and long-term outcomes as those from older donors.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Child
  • Child, Preschool
  • Delayed Graft Function / etiology
  • Female
  • Graft Rejection / etiology
  • Graft Survival*
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Kidney Transplantation* / adverse effects
  • Kidney Transplantation* / mortality
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Proteinuria / etiology
  • Risk Assessment
  • Survivors*
  • Time Factors
  • Tissue Donors*
  • Treatment Outcome