Long-Term Success with Double Pediatric Cadaver Donor Renal Transplants

Joseph R. Schneider, David E.R. Sutherland, Richard L. Simmons, David S. Fryd, John S. Najarian

Annals of Surgery · 1983 · 43 citations · 15 references

Concepts

TL;DR

Many institutions hesitate to use pediatric cadaver kidneys for transplantation because of concerns about technical complications and the limited functional renal tissue they provide. Between 1971 and 1981 the authors performed 21 double pediatric cadaver donor renal transplants and compared graft and patient survival with a control group of 39 computer‑matched adult cadaver kidney recipients and all nonmatched recipients using actuarial analysis. Eleven grafts remained functional for up to 11 years, only one was lost to a technical complication, and survival outcomes were statistically indistinguishable from adult kidney recipients, supporting the use of pediatric kidneys whenever available.

Abstract

Many institutions are reluctant to use pediatric cadaver kidneys for transplantation because of a fear of an increased risk of technical complications or because these grafts leave the recipient with a relatively small amount of functioning renal tissue. From 1971 to 1981 the authors performed 21 double pediatric cadaver donor renal transplants. Eleven of these grafts are currently functioning for periods up to 11 years post-transplant. Only one graft was lost due to a technical complication. Using actuarial analysis, the graft survival and patient survival in this group of patients was compared with a control group of 39 computer matched and randomly selected recipients of adult cadaver kidneys and to all nonmatched recipients of cadaver kidneys during the same time period. There were no statistically significant differences among the three groups in graft survival or in patient survival. It is concluded that the long-term results with double pediatric cadaver kidney transplants are the same as those using single adult cadaver kidneys. Pediatric kidneys should be used whenever they are available so that transplantation can be extended to more patients.

References

15