Comparative analysis of single pediatric kidney transplantation from pediatric donors between donors aged <2 years and 2-18 years
10.3760/cma.j.cn421203-20231126-00176
- VernacularTitle:小于2岁与2~18岁儿童遗体捐献供者供肾儿童单肾移植疗效对比分析
- Author:
Runtao FENG
1
;
Ming ZHAO
1
;
Jianmin HU
1
;
Song ZHOU
1
;
Jun LIAO
1
;
Zijian LI
1
;
Yongguang LIU
1
Author Information
1. 南方医科大学珠江医院器官移植科，广州 510280
- Publication Type:Journal Article
- Keywords:
Child;
Kidney transplantation;
Organ donation;
Thrombosis;
Postoperative hemorrhage;
Rejection
- From:
Chinese Journal of Organ Transplantation
2024;45(12):878-884
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the efficacy of single kidney transplantation (KT) from pediatric donors between donors aged <2 and 2- 18 years.Methods:Between August 2016 and May 2023, 127 single pediatric kidney transplantations involving pediatric donors were conducted. They were assigned into two subgroups based upon age of small pediatric donors (n=22, SPD, donors aged <2 years) and normal pediatric donors (n=105, NPD, donors aged 2-18 years). A retrospective analysis was performed to compare recipient/donor baseline characteristics, postoperative complications and recipient/graft survival rates between two groups.Results:Significant inter-group differences existed in donor age[11.0 (10.0, 15.0) vs 121.0 (74.0, 166.0) month], donor weight[8.3 (8.0, 9.4) vs 30.0 (20.0, 50.0) kg]and graft-to-recipient weight ratio[0.3 (0.2, 0.5) vs 1.0 (0.6, 1.5) ] ( P<0.001). Conversely, no significant inter-group differences existed in donor gender/type, warm/cold ischemic time, human leukocyte antigen mismatch number, estimated glomerular filtration rate, recipient gender/age/weight, number of transplants, preoperative dialysis, preoperative induction therapy, panel-reactive antibody or primary disease ( P>0.05). The incidence of vascular thrombosis was 9.1% (2/22) and 0 in SPD and NPD groups with statistically significant differences ( P=0.029) ; the incidence of post-transplant hemorrhage was 13.6% (3/22) and 1.9% (2/105) with statistically significant difference ( P=0.036). However, no statistically significant inter-group differences existed in recurrent renopathy, delayed graft function or 1-year cumulative incidence of acute rejection ( P>0.05). Six recipients (27.3%) in SPD group lost allografts due to recurrent or primary nonfunction (n=1), vascular thrombosis (n=2), post-transplant hemorrhage (n=2) and thrombotic microangiopathy (n=1). In comparison, three recipients (2.9%) in NPD group lost allografts due to rejection (n=2) and infectious rupture of transplanted renal artery (n=1). Three-year recipient survival rates were 100% and 99.0% in SPD and NPD groups with no statistically significant differences ( P=0.600). And 3-year death-censored graft survival was significantly lower in SPD group than that in NPD groups (77.3% vs 91.5%) ( P<0.001, HR=8.3, 95% CI: 2.0-34.2) . Conclusions:Early postoperative vascular complications after single pediatric KT from pediatric donors aged under 2 years are frequent and predispose to graft loss.
