The implications of donor-recipient size mismatch in renal transplantation

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

“…Moreover, Lepeytre et al 17 showed a shorter graft survival when donor/recipient BSA ratio is less than 0.8 in a study involving 136 321 adult deceased‐donor renal transplants. In addition, Kostakis et al 18 analyzed 26 223 single‐kidney transplants in adult recipients. This group found a higher DGF risk in renal transplants with BSAi ≤ 0.75 coming from living donors and donors after brain death.…”

“…[11][12][13][14] Thus, a small number of large studies have investigated whether the relation between donor and recipient size, expressed using BSA, has an impact on renal transplant outcomes. All these included adult recipients [15][16][17][18] but two, one that included adolescent recipients 24 and one that included both adult and pediatric recipients. 30 Lee et al 15 Note: Bold values correspond to statistically significant.…”

“…[11][12][13][14] 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][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.…”

“…There is strong evidence in the literature that kidney size correlates well with body size as it is estimated by body surface area (BSA) 11–14 . 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 …”

Novel Histopathologic and Ultrastructural Findings in Renal Allografts From Patients With Size and Age Mismatches: A Case Series

“…the donor and recipient exhibit discrepancies in either body size or kidney size). Most research in this area has focused on the use of body surface area (BSA) or body mass index (BMI) to predict allograft outcomes and describe non-HLA donor mismatches [6][7][8][9]. However, there is growing evidence that age also plays a role in the pathologic changes observed in allografts in the post-transplant period that could also predict outcomes for kidney transplant recipients [7,10,11].…”