PMID- 10634019
OWN - NLM
STAT- MEDLINE
DCOM- 20000201
LR  - 20161013
IS  - 0929-6646 (Print)
IS  - 0929-6646 (Linking)
VI  - 98
IP  - 12
DP  - 1999 Dec
TI  - Long-term results with pediatric kidney transplants in adult recipients.
PG  - 807-13
AB  - The shortage of donor kidneys available for transplantation has resulted in an 
      expansion of the criteria used for donor selection. The use of cadaveric 
      pediatric kidneys has been suggested as a means to overcome this shortage, but is 
      debated because of technical complications and an increased incidence of 
      functional allograft impairment. We examined the records of all adult patients 
      receiving renal allograft transplants from January, 1983 through December 1994, 
      to determine whether kidneys from pediatric donors can be used safely for 
      transplantation. During the study period, 204 adult patients received kidney 
      transplants. The patients were divided into three groups by donor age: group 1, 
      26 months to 7 years old (n = 12); group 2, 7 to 14 years old (n = 19); and group 
      3, adult donors (n = 173). Cyclosporine- and/or azathioprine-based 
      immunosuppression regimens were used. The three groups did not differ from one 
      anther with respect to recipient age, recipient sex, primary renal disease, human 
      leukocyte antigen (HLA) mismatching, or the proportion of recipients with 
      previous transplants. The graft survival rates at 1 and 3 years, respectively, 
      were 75% and 75% in group 1,84% and 79% in group 2, and 85% and 72% in group 3 (p 
      > 0.05). The patient survival rates at 1 and 3 years, respectively, were 75% and 
      75% in group 1,95% and 90% in group 2, and 90% and 83% in group 3 (p > 0.05). The 
      frequency of fixed proteinuria (> or = 0.8 gm/day) in the first 3 years was 
      higher in the two pediatric groups (50%) than in the adult group (28%) (p < 
      0.05). The frequency of surgical complications was higher with pediatric grafts 
      (group 1 vs group 3: 67% vs 24%, p < 0.005). In particular, group 1 patients had 
      much higher rates of lymphocele (50% vs 8%), renal graft artery stenosis (33% vs 
      11%), and hydronephrosis (33% vs 9%) than group 3. We conclude that pediatric 
      donor kidneys can be used with reasonable safety, although surgical complications 
      remain a major problem.
FAU - Chen, C H
AU  - Chen CH
AD  - Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan.
FAU - Shu, K H
AU  - Shu KH
FAU - Yang, C R
AU  - Yang CR
FAU - Cheng, C H
AU  - Cheng CH
FAU - Wu, M J
AU  - Wu MJ
FAU - Lian, J D
AU  - Lian JD
LA  - eng
PT  - Journal Article
PL  - Singapore
TA  - J Formos Med Assoc
JT  - Journal of the Formosan Medical Association = Taiwan yi zhi
JID - 9214933
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Survival
MH  - Humans
MH  - *Kidney Transplantation/mortality
MH  - Male
MH  - Prognosis
MH  - Survival Rate
MH  - *Tissue Donors
EDAT- 2000/01/14 00:00
MHDA- 2000/01/14 00:01
CRDT- 2000/01/14 00:00
PHST- 2000/01/14 00:00 [pubmed]
PHST- 2000/01/14 00:01 [medline]
PHST- 2000/01/14 00:00 [entrez]
PST - ppublish
SO  - J Formos Med Assoc. 1999 Dec;98(12):807-13.