Paediatric kidney transplants from donors aged 1 year and under

an analysis of the Australian and New Zealand Dialysis and Transplant Registry from 1963 to 2018

Jinna Yao, Philip A. Clayton, Kate Wyburn, Harsham Choksi, Elena Cavazzoni, David Tovmassian, Howard M. H. Lau, Richard Allen, Lawrence Yuen, Jerome M. Laurence, Vincent W. T. Lam, Henry C. C. Pleass*

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Kidneys from very small donors have the potential to significantly expand the donor pool. We describe the collective experience of transplantation using kidneys from donors aged ≤1 year in Australian and New Zealand. The ANZDATA registry was analysed on all deceased donor kidney transplants from donors aged ≤1 year. We compared recipient characteristics and outcomes between 1963–1999 and 2000–2018. From 1963 to 1999, 16 transplants were performed [9 (56%) adults, 7 (44%) children]. Death‐censored graft survival was 50% and 43% at 1 and 5 years, respectively. Patient survival was 90% and 87% at 1 and 5 years, respectively. From 2000 to 2018, 26 transplants were performed [25 (96%) adults, 1 (4%) children]. Mean creatinine was 73 µmol/l ±49.1 at 5 years. Death‐censored graft survival was 85% at 1 and 5 years. Patient survival was 100% at 1 and 5 years. Thrombosis was the cause of graft loss in 12% of recipients in the first era from 1963 to 1999, and 8% of recipients in the second era from 2000 to 2018. We advocate the judicious use of these small paediatric grafts from donors ≤1 year old. Optimal selection of donor and recipients may lead to greater acceptance and success of transplantation from very young donors.

Original languageEnglish
Pages (from-to)118-126
Number of pages9
JournalTransplant International
Volume34
Issue number1
Early online date17 Oct 2020
DOIs
Publication statusPublished - 1 Jan 2021

Keywords

  • en bloc transplant
  • infant donors
  • kidney transplant
  • organ procurement
  • paediatric donor
  • surgical complications

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