Author/Authors :
Mahdavi, Reza Department of Kidney Transplantation - Imam Reza Hospital - Mashhad University of Medical Sciences, Mashhad , Arab, Davood Department of Kidney Transplantation - Imam Reza Hospital - Mashhad University of Medical Sciences, Mashhad , Taghavi, Rahim Department of Kidney Transplantation - Imam Reza Hospital - Mashhad University of Medical Sciences, Mashhad , Gholamrezaie, Hamid Reza Department of Kidney Transplantation - Chamran Hospital - Tehran Medical Branch Islamic Azad University, Tehran , Yazdani, Mohammad Department of Kidney Transplantation - Khorshid Hospital - Esfahan University of Medical Sciences, Isfahan , Simforoosh, Nasser Department of Kidney Transplantation - Shaheed Labbafinejad Medical Center - Shaheed Beheshti University of Medical Sciences, Tehran , Tabibi, Ali Department of Kidney Transplantation - Shaheed Labbafinejad Medical Center - Shaheed Beheshti University of Medical Sciences, Tehran
Abstract :
Introduction: The shortage of cadaveric donors for kidney transplantation has led
to the expansion of the criteria used for donor selection, such as the use of pediatric
cadaveric donors. In this study we reviewed our results of en bloc kidney
transplantation of pediatric cadaveric donors to adults.
Materials and Methods: From May 2001 to May 2005, 245 cadaveric kidney
transplants have been performed in our hospitals. Seven of these were en bloc kidney
transplantations in adult recipients from marginal pediatric donors (age < 5 years,
donor weight < 15 kg, high creatinine clearance, or kidney length < 8 cm). We reviewed
their records. Follow-up (range, 3 to 24 months) included ultrasonography,
dimercaptosuccinic acid renal scintigraphy, and magnetic resonance imaging.
Results: Serum levels of creatinine ranged between 0.8 m/dL to 1.9 mg/dL during
the follow-up period. One patient died of myocardial infarction 3 months
postoperatively. One-year graft and patient survivals were both 85.7%. Complications
included acute tubular necrosis in 1 patient (managed by conservative therapy and
dialysis for 2 weeks), renal vein thrombosis in 1 (treated by anticoagulation), and
subcutaneous hematoma in 1. There were no urologic complications. Median size of
the grafts was 7.2 cm preoperatively that reached 9.6 cm, 3 months postoperatively
(P = .018). Twelve months following operation, the median size of the grafts reached
11 cm (P = .045).
Conclusion: En bloc pediatric kidney transplantation is a safe and suitable alternative for adult recipients. One-year graft and patient survivals are acceptable and complication rate is low.
