Long-term outcomes of adult-size and size-matched kidney transplants in small pediatric recipients

Amesty, Maria Virginia; Fernández, C.; Espinosa, Laura; Rivas-Vila, Susana; Lobato, Roberto; Monsalve, Shirley; Pereira, P. López; Martinez-Urrutia, Maria Jose

doi:10.1016/j.jpurol.2020.05.012

Cited by 7 publications

(11 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It seems that compensatory mechanisms exist that regulate the size of the transplanted kidney, by regulating the size of its glomeruli mainly, to meet the recipient's metabolic needs as they are indicated by his/her body size 9,10,22,28,29 . Müller‐Deile et al 28 reported that there is a significant increase in renal graft size within the first 6 months after renal transplant when an infant donates to a child or an adult, and when a child donates to an adult.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, a few studies have tried to use the donor's size as an indirect way to evaluate renal graft size and assess the role of size mismatch between donor and recipient in renal transplantation, mainly focusing on adult population 15–18 . However, the role of renal graft size, and size mismatch between donor and recipient has not been adequately investigated in the pediatric population, with only a small number of studies looking into this 19–24 …”

Section: Introductionmentioning

confidence: 99%

“…[15][16][17][18] However, the role of renal graft size, and size mismatch between donor and recipient has not been adequately investigated in the pediatric population, with only a small number of studies looking into this. [19][20][21][22][23][24] Pediatric renal transplant recipients represent a unique population with respect to challenges in size mismatch, which are more obvious the younger the child is. Renal grafts for pediatric recipients are derived from adult living donors, adult deceased donors, or pediatric deceased donors, resulting in a wide range of donor-recipient size ratio, and therefore, a wide range of renal graft size relative to recipient's size.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pediatric renal transplantation—A UNOS database analysis of donor–recipient size mismatch

Kostakis

Chandak

Assia‐Zamora

et al. 2023

Pediatric Transplantation

View full text Add to dashboard Cite

Background We used the BSAi (Donor BSA/Recipient BSA) to assess whether transplanting a small or large kidney into a pediatric recipient relative to his/her size influences renal transplant outcomes. Methods We included 14 322 single‐kidney transplants in pediatric recipients (0–17 years old) (01/2000–02/2020) from the United Network for Organ Sharing database. We divided cases into four BSAi groups (BSAi ≤ 1, 1 < BSAi ≤ 2, 2 < BSAi ≤ 3, BSAi > 3). Results There were no differences concerning delayed graft function (DGF) or primary non‐function (PNF) rates, whether the grafts were from living or brain‐dead donors. In both transplants coming from living donors and brain‐dead donors, cases with BSAi > 3 and cases with 2 < BSAi ≤ 3 had similar graft survival (p = .13 for transplants from living donors, p = .413 for transplants from brain‐dead donors), and both groups had longer graft survival than cases with 1 < BSAi ≤ 2 and cases with BSAi ≤ 1 (p < .001). The difference in 10‐year graft survival rates between cases with BSAi > 3 and cases with BSAi ≤ 1 reached around 25% in both donor types. The better graft survival in transplants with BSAi > 2 was confirmed in multivariable analysis. Conclusions There is no significant impact of donor‐recipient size mismatch on DGF and PNF rates in pediatric renal transplants. However, graft survival is significantly improved when the donor's size is more than twice the pediatric recipient's size.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric renal transplantation—A UNOS database analysis of donor–recipient size mismatch

Kostakis

Chandak

Assia‐Zamora

et al. 2023

Pediatric Transplantation

View full text Add to dashboard Cite

show abstract

“…Kidney transplantation in children under the age of 1-year is rare (0.5-5% of all pediatric kidney transplantations) and poses surgical challenges in terms of size differences in body cavity and vessel diameters (67,68). Previous studies use various definitions of "very small children" ranging from younger than 1 or 2 years of age to a weight below 10, 15, or 20 kg (69)(70)(71)(72)(73).…”

Section: Kidney Transplantation In Small Childrenmentioning

confidence: 99%

“…Currently, there is no consensus on a minimal age or weight for transplantation. Whereas, some centers perform transplantations in children above 6 kg, others use a minimum age of 2 years (69,72,87). Further work is required to determine optimal timing with regard to long term outcome.…”

Section: Timingmentioning

confidence: 99%

Pearls and Pitfalls in Pediatric Kidney Transplantation After 5 Decades

et al. 2022

View full text Add to dashboard Cite

Worldwide, over 1,300 pediatric kidney transplantations are performed every year. Since the first transplantation in 1959, healthcare has evolved dramatically. Pre-emptive transplantations with grafts from living donors have become more common. Despite a subsequent improvement in graft survival, there are still challenges to face. This study attempts to summarize how our understanding of pediatric kidney transplantation has developed and improved since its beginnings, whilst also highlighting those areas where future research should concentrate in order to help resolve as yet unanswered questions. Existing literature was compared to our own data of 411 single-center pediatric kidney transplantations between 1968 and 2020, in order to find discrepancies and allow identification of future challenges. Important issues for future care are innovations in immunosuppressive medication, improving medication adherence, careful donor selection with regard to characteristics of both donor and recipient, improvement of surgical techniques and increased attention for lower urinary tract dysfunction and voiding behavior in all patients.

show abstract

Donor-Recipient Size Mismatch in Pediatric Renal Transplantation

Cho¹

2023

Pediatric Solid Organ Transplantation

View full text Add to dashboard Cite

Long-term outcomes of adult-size and size-matched kidney transplants in small pediatric recipients

Cited by 7 publications

References 28 publications

Pediatric renal transplantation—A UNOS database analysis of donor–recipient size mismatch

Pediatric renal transplantation—A UNOS database analysis of donor–recipient size mismatch

Pearls and Pitfalls in Pediatric Kidney Transplantation After 5 Decades

Donor-Recipient Size Mismatch in Pediatric Renal Transplantation

Contact Info

Product

Resources

About