Pediatric kidney transplantation: outcomes with under and over 6-year-old donors

儿童肾移植:6 岁以下和 6 岁以上捐献者的结局

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作者:Simone Lysakowski, Clotilde Druck Garcia, Roberta Weisheimer Rohde, Santo Pascual Vitola, Fabian Silva Pires, Vandrea Carla de Souza, Pedro Enrico Ventura, Roger Kist

Conclusions

Small donors can be considered for pDDKTs, as long as there is an expert team to perform the transplantation.

Objective

Kidney shortage for pediatric kidney transplantation (PKT) entails the need to use low-weight and age donors, despite the apprehension. The aim of this study was to analyze the pediatric deceased donor kidney transplantations (pDDKT) outcomes in the first year after the procedure, stratified by donor age. Method: Retrospective cohort of pDDKTs carried out between January 2013, and January 2018, at a PKT reference hospital in Southern Brazil. Donors were divided into group 1 (≤ 6 years), and group 2 (> 6 years); the analysis of the outcomes was carried out in the same period.

Results

There were 143 pDDKTs; 51 (35.66%) in group 1; and 92 (64.34%) in group 2. In both groups there were 17 graft losses (11.8%), with vascular thrombosis as the main cause (group 1: 5; group 2: 4). Among the complications, renal artery stenosis (RAS) with indication for angioplasty and stenting was more frequent in group 1 (7.8%; group 2: 2.2%). The 1-year Renal Transplant Recipients' and graft survival did not show significant differences between the groups, (p = = 0.95). However, the Glomerular Filtration Rate analysis was higher in group 2, reaching, in the 12th month, 79.3 mL/min/1,73m2, compared to 69.7 mL/min/1,73m2 in group 1(p = = 0.033). Conclusions: Small donors can be considered for pDDKTs, as long as there is an expert team to perform the transplantation.

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