Kidney Week

Abstract: PO1970

Encouraging Outcomes from Using a Small-Donor Single Graft in Pediatric Kidney Transplantation

Session Information

• Pediatric Nephrology: AKI, Dialysis, Transplant, CKD, and Nephrotic Syndrome
  November 04, 2021 | Location: On-Demand, Virtual Only
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1700 Pediatric Nephrology

Authors

• Feltran, Luciana S., Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Luciana S. Feltran, MD

• Carvalho, Maria fernanda Camargo, Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Maria fernanda Camargo Carvalho,

• Koch Nogueira, Paulo C., Hospital Samaritano de Sao Paulo, Sao Paulo, São Paulo, Brazil

Paulo C. Koch Nogueira,

Background

The use of small pediatric kidneys as single for transplantation is controversial, due to the potential risk for graft thrombosis and insufficient nephron mass.

Methods

Aiming to test the benefits of transplanting these kidneys, 375 children who underwent kidney transplantation in a single center were evaluated: 49 (13.1%) received a single graft from a small pediatric donor (≤15Kg, SPD group), 244 (65.1%) from a bigger pediatric donor (>15Kg, BPD group) and 82 (21.9%) from adult living donors (group ALD).

Results

Groups had similar baseline main characteristics. After 5 years of follow-up, children from SPD group were comparable to children from BPD and ALD in patient survival (94, 96, and 98%, p=0.423); graft survival (89, 88, and 93%, p=0.426); the frequency of acute rejection (p=0.998); the incidence of post-transplant lymphoproliferative disease (p=0.671); the rates of vascular thrombosis (p=0.846); and the necessity for post-transplant surgical intervention prior to discharge (p=0.905). The longitudinal evolution of eGFR was not uniform among groups. The 3 groups presented a decrease in the eGFR, but the slope of the curve was steeper in ALD children. At 5 years, the eGFR of ALD group was 10 ml/min/1.73m² inferior to the others. At that time, the eGFR from SPD group was statistically similar to the BPD (p=0.952).

Conclusion

In a specialized transplant center, the use of small single pediatric donor kidneys is as successful as bigger pediatric donors or adult living donors in transplants after 5 years of follow-up.