Impact and Application of Donor/Recipient Body Surface Area on Kidney Transplantation from Pediatric Donor to Adult Recipient.

Abstract Background Insufficient nephron dosing is closely associated with poor graft function and graft loss. Donor/recipient body surface area (D/R BSA) has been proven to be one of the useful predictors for sufficient nephron dosing. However, little is known regarding the impact and application of D/R BSA on kidney transplantation from pediatric donor to adult recipient. Methods We retrospectively analyzed 26 cases of kidney transplantations from pediatric donors to adult recipients, which were performed in our center from 2010 through 2014. Patients were divided into 2 groups based on D/R BSA: group A,  Results All demographics and early postoperative complications of group A were similar to those of group B ( P > .05). eGFR in group A and group B at 1, 3, 6, and 12 months after transplantation were: 63.2 ± 5.0 vs 74.0 ± 7.6 ( P  = .008), 66.2 ± 4.9 vs 75.8 ± 5.9 ( P  = .004), 69.0 ± 4.8 vs 79.0 ± 6.3 ( P  = .004), and 69.4 ± 7.9 vs 79.2 ± 8.4 ( P  = .033). Short-term graft survival of group A was inferior to that of group B (62.5% vs 94.4%; P  = .042). Conclusions We conclude that recipients with high D/R BSA are more likely to have better graft function. It is possible to make optimal allocation of pediatric donor kidneys on the basis of D/R BSA ≥0.8.