Donation after cardiac death pediatric en bloc renal transplantation

Marie Dion; Neal Rowe; Jeffrey Shum; Corinne Weernink; Sarah Felbel; Vivian C McAlister; Alp Sener; Patrick P Luke

doi:10.1016/j.juro.2014.07.089

Donation after cardiac death pediatric en bloc renal transplantation

J Urol. 2015 Jan;193(1):281-5. doi: 10.1016/j.juro.2014.07.089. Epub 2014 Jul 24.

Authors

Marie Dion¹, Neal Rowe², Jeffrey Shum³, Corinne Weernink⁴, Sarah Felbel², Vivian C McAlister³, Alp Sener², Patrick P Luke⁵

Affiliations

¹ Department of Surgery, Division of Urology, Western University, London, Ontario, Canada.
² Department of Surgery, Division of Urology, Western University, London, Ontario, Canada; Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada.
³ Department of General Surgery, Western University, London, Ontario, Canada; Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada.
⁴ Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada.
⁵ Department of Surgery, Division of Urology, Western University, London, Ontario, Canada; Multi-Organ Transplant Program, London Health Sciences Center, London, Ontario, Canada. Electronic address: Patrick.Luke@lhsc.on.ca.

PMID: 25066870
DOI: 10.1016/j.juro.2014.07.089

Abstract

Purpose: Use of small pediatric kidneys obtained from extremely young donors after cardiac death has been limited. This potential organ source remains under used by transplant teams.

Materials and methods: We reviewed all renal transplants at our institution from 2000 to 2013 to identify recipients of an en bloc pair of kidneys from deceased pediatric donors younger than 4 years. The outcomes of donation after cardiac death en bloc allografts were compared with neurological determination of death en bloc allografts.

Results: A total of 21 recipients of en bloc renal allografts were identified, of which 4 organ pairs were obtained through donation after cardiac death. Mean ± SD donor age was 20.6 ± 11.6 months and weight was 12.4 ± 3.7 kg. Delayed allograft function occurred in 2 of 4 recipients of allografts obtained from donation after cardiac death en bloc and 3 of 17 recipients of allografts from neurological determination of death en bloc. One year after transplantation mean ± SD glomerular filtration rates were similar, at 80.7 ± 15.3 and 85.7 ± 33.4 ml/minute/1.73 m(2) in the cardiac and neurological allograft groups, respectively (difference not significant). Surgical complications occurred in 3 patients, and no allograft was lost to thrombosis.

Conclusions: We report successful transplantation of a small cohort of pediatric en bloc kidneys obtained through donation after cardiac death from donors younger than 4 years. Outcomes at 1 year are comparable to those in neurological determination of death en bloc allograft recipients.

Keywords: donor selection; kidney transplantation; tissue and organ procurement.

Publication types

Comparative Study

MeSH terms

Age Factors
Death
Graft Survival
Humans
Infant
Kidney Transplantation*
Postoperative Complications
Retrospective Studies
Tissue Donors*
Tissue and Organ Procurement*