PMID- 24224847
OWN - NLM
STAT- MEDLINE
DCOM- 20140814
LR  - 20131205
IS  - 1399-0012 (Electronic)
IS  - 0902-0063 (Linking)
VI  - 27
IP  - 6
DP  - 2013 Nov-Dec
TI  - Organ allocation in pediatric renal transplants: is there an optimal donor?
PG  - 938-44
LID - 10.1111/ctr.12272 [doi]
AB  - The 2005 revised allocation scheme for pediatric renal transplantation made the 
      decision of whether to transplant an available living-donor (LD) kidney or use a 
      deceased-donor (DD) kidney controversial. The aim of this study was to examine 
      kidney allograft utilization, sensitization, and outcomes of pediatric transplant 
      recipients. Between January 2000 and December 2009, 91 consecutive pediatric 
      kidney recipients (<20 yr) were transplanted. The LD (n = 38) and DD (n = 53) 
      groups were similar in age, gender, dialysis status at transplant, warm ischemia 
      time, and overall patient survival. LD recipients were more likely to be 
      Caucasian (92 vs. 69%), receive older allografts (39 +/- 10 vs. 23 +/- 9 yr), and 
      have fewer human leukocyte antigen (HLA) mismatches (3.3 +/- 1.6 vs. 4.4 +/- 1.5, p < 
      0.01 for all). Graft survival at one, three, and five yr post-transplant was 
      longer for LD recipients (97%, 91%, 87% vs. DD 89%, 79%, 58%, respectively, p < 
      0.05). At the time of transplant, 17 (33%) DD recipients had an available LD 
      (mean age 40 yr). A greater proportion of all patients were moderately (PRA 
      21-79%) sensitized post-transplant (p < 0.05). A multivariable analysis of graft 
      survival indicated that the advantage in LD organs was likely due to fewer HLA 
      mismatched in this group. Nonetheless, LD organs appear to provide optimal 
      outcomes in pediatric renal transplants when considering the risk of becoming 
      sensitized post-transplant complicating later use of the LD kidney.
CI  - (c) 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Pitt, Susan C
AU  - Pitt SC
AD  - Section of Transplant Surgery, Department of Surgery, Washington University 
      School of Medicine, St. Louis, MO, USA.
FAU - Vachharajani, Neeta
AU  - Vachharajani N
FAU - Doyle, Maria B
AU  - Doyle MB
FAU - Lowell, Jeffrey A
AU  - Lowell JA
FAU - Chapman, William C
AU  - Chapman WC
FAU - Anderson, Christopher D
AU  - Anderson CD
FAU - Shenoy, Surendra
AU  - Shenoy S
FAU - Wellen, Jason R
AU  - Wellen JR
LA  - eng
PT  - Journal Article
DEP - 20131113
PL  - Denmark
TA  - Clin Transplant
JT  - Clinical transplantation
JID - 8710240
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Follow-Up Studies
MH  - Glomerular Filtration Rate
MH  - Health Care Rationing/*standards
MH  - Humans
MH  - Kidney Failure, Chronic/mortality/*surgery
MH  - Kidney Function Tests
MH  - *Kidney Transplantation
MH  - Male
MH  - Prognosis
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Survival Rate
MH  - Tissue Donors/*supply & distribution
MH  - Tissue and Organ Procurement/*standards
MH  - Young Adult
OTO - NOTNLM
OT  - deceased donors
OT  - living donors
OT  - pediatric kidney transplant
OT  - sensitization
OT  - transplant outcomes
EDAT- 2013/11/15 06:00
MHDA- 2014/08/15 06:00
CRDT- 2013/11/15 06:00
PHST- 2013/09/30 00:00 [accepted]
PHST- 2013/11/15 06:00 [entrez]
PHST- 2013/11/15 06:00 [pubmed]
PHST- 2014/08/15 06:00 [medline]
AID - 10.1111/ctr.12272 [doi]
PST - ppublish
SO  - Clin Transplant. 2013 Nov-Dec;27(6):938-44. doi: 10.1111/ctr.12272. Epub 2013 Nov 
      13.