Received September 11, 2008
Accepted on June 9, 2009

ORIGINAL ARTICLES

Long-Term Outcome of Adults Who Undergo Transplantation with Single Pediatric Kidneys: How Young Is too Young?

Rubin Zhang ^*1, Anil Paramesh , Sandy Florman , C. Lillian Yau , Saravanan Balamuthusamy ^*, N. Kevin Krane ^*, and Douglas Slakey

Departments of *Medicine and Surgery, School of Medicine, and Department of Biostatistics, School of Public Health and Tropic Medicine, Tulane University, New Orleans, Louisiana

¹ To whom correspondence should be addressed. E-mail: rzhang{at}tulane.edu.

	Abstract

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.