En bloc transplantation of pediatric donor kidneys to adult receptors

OBJECTIVES: Analysis of all pediatric donor en bloc transplants to adult receptors performed in our department. METHODS: Retrospective analysis of 73 en bloc kidney transplants and 497 adult transplants performed in our centre from 1990 to 2004. Mean follow-up was 50.23 months (10.18-89.05 months). All patients received the same immunosuppression, although it evolved with time. RESULTS: There were significant differences in terms of nonfunctioning kidneys and delayed graft function, more frequent in pediatric en bloc and adult transplants, respectively. Pediatric kidneys provided better renal function and less proteinuria. Patient and graft survivals were similar in both groups. One and five-year graft survivals were 83.56% and 8 1.47% for pediatric donor kidneys, and 91.50% and 86.99% for adult donor kidneys. Vascular complications were the most frequent cause of graft loss for the en bloc transplants. CONCLUSIONS: Pediatric donor en bloc transplants have an excellent survival and function in the middle and long-term. Vascular complications are the main cause of pediatric donor graft loss. The adoption of a pediatric donor en bloc transplant program increases the transplant activity.