Eleven cases of solitary kidney transplantation from pediatric donor after controlled circulatory death into adult recipient

Objective To summarize the experience of single kidney from pediatric donors after controlled circulatory death transplanted into adult patients.Methods A retrospective single-center review of all adult recipients who received a single pediatric kidney from controlled cardiac deceased donor≤9-year old between January 2006 and March 2008.All donors were diagnosed as brain death and their parents signed the agreement of donation.Patients were observed for 5 to 15 min before cardiac death was declared and the organ-donation process initiated.The mean age and weight were(75.3±22.8)months and(23.9±8.4)kg of the pediatric donors,and(28.2±7.9)years and(46.9±4.2)kg of the aduh recipients.Single kidneys with more than 6cm in length were implanted into the right iliac fossa of recipients through same surgical procedures as in adult cadaveric renal transplantation.Immunosuppression consisted of induction therapy with poly/mono-clone immunoglobulin begun in the operating room prior to revascularization of the graft and continued for 7 days,followed by cyclosporine or tacrolimus-based triple therapy.Results All recipients recovered normal kidney function before leaving hospital.Three of them had delayed graft function.The graft lengths recorded immediately after reperfusion and that in the first week post-transplantation were 70.6±5.5 vs.86.1±6.9 mm (P＜0.00 1).Acute rejection episodes occurred in 1 patient.The one year patient/graft survival was 100%/100%.Conclusions Single kidneys more than 6 cm in length from pediatric donors after controlled cardiac death transplanted into adult recipients with small body mass index can successfully maintain normal renal function.The use of these grafts could expand the donor pool without comprising recipient outcomes. Key words: Tissue donors; Kidney transplantation