ADULT-SIZE KIDNEYS WITHOUT ACUTE TUBULAR NECROSIS PROVIDE EXCEEDINGLY SUPERIOR LONG-TERM GRAFT OUTCOMES FOR INFANTS AND SMALL CHILDREN

Abstract

Increased donor tissue mass of the ASK or kidney-liver transplants, in the absence of ATN, seems to confer a protective effect to infant and small child recipients of these allografts. This is manifested by a prolonged rejection-free state in the single center experience and enhanced graft survival and function in the UNOS analysis, comparable to HLA identical sibling transplants for LD infant and small child recipients and to LD adult results for CAD infant and small child recipients. To optimize this protective effect by whatever mechanism, absolute avoidance of ATN is essential in infant recipients of ASK or combined kidney-liver transplants.