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Kidney Week

Abstract: TH-PO1159

Kidney Transplantation from Small Pediatric Donors May Be Feasible to Those Who Developed Chronic Refractory Dialysis Hypotension: A Single-Center Experience

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Author

  • Hanying, Jia, The first affiated hospital of Zhejiang University, Hangzhou, China
Background

Chronic refractory dialysis hypotension (CRDH) is a serious issue in dialysis patients waiting for transplants. CRDH leads to fatal clinical outcomes and disqualification from kidney transplantation. Kidney transplantation from small pediatric donors to adult patients with lower blood pressure(BP) may be an option. To our knowledge, there has been no report on the benefit of transplantation from pediatric donors to CRDH recipients.

Methods

Ten single-kidney transplantations from five small pediatric donors after cardiac death in our center between August 2016 and April 2018 were analyzed. Half of the recipients were CRDH (group A) and each of them was matched with no-CRDH patient (control, group B) from same deceased pediatric donor. The operation method of vascular anastomosis and ureterocystoneostomy was the same as that of adult donors. Clinical characteristics, post-operative treatment and outcomes were retrieved. Postoperative BP, graft function and size were compared between the two groups. The follow-up time was up to April 2019.

Results

There were no acute rejection, graft loss or death in CRDH patients after kidney transplantation. The postoperative systolic BP in four recipients in group A was above 100mmHg persistently. Their renal function was recovered despite three transient delayed graft function (2 in group A and 1 in group B). There was no significant difference in serum creatinine or graft size (P=0.84, 0.94) after transplantation between two groups.

Conclusion

In conclusion, kidney transplantation from small pediatric donors may be feasible to CRDH patients and their BP may return to normal after transplantation.