دورية أكاديمية
أعرض في EDS

Encouraging outcomes of using a small-donor single graft in pediatric kidney transplantation.

التفاصيل البيبلوغرافية
العنوان: Encouraging outcomes of using a small-donor single graft in pediatric kidney transplantation.
المؤلفون: de Santis Feltran L; Department of Pediatric Kidney Transplantation, Hospital Samaritano de São Paulo, Rua Guapiaçu 121-91, São Paulo, SP, 04024-020, Brazil. glfeltran@uol.com.br., Genzani CP; Department of Pediatric Kidney Transplantation, Hospital Samaritano de São Paulo, Rua Guapiaçu 121-91, São Paulo, SP, 04024-020, Brazil., Hamamoto F; Department of Pediatric Kidney Transplantation, Hospital Samaritano de São Paulo, Rua Guapiaçu 121-91, São Paulo, SP, 04024-020, Brazil., Fonseca MJBM; Department of Pediatric Kidney Transplantation, Hospital Samaritano de São Paulo, Rua Guapiaçu 121-91, São Paulo, SP, 04024-020, Brazil., de Camargo MFC; Department of Pediatric Kidney Transplantation, Hospital Samaritano de São Paulo, Rua Guapiaçu 121-91, São Paulo, SP, 04024-020, Brazil., de Oliveira NLG; Department of Pediatric Kidney Transplantation, Hospital Samaritano de São Paulo, Rua Guapiaçu 121-91, São Paulo, SP, 04024-020, Brazil., de Freitas Amaral FC; Department of Pediatric Kidney Transplantation, Hospital Samaritano de São Paulo, Rua Guapiaçu 121-91, São Paulo, SP, 04024-020, Brazil., Baptista JC; Department of Vascular Surgery, Federal University of São Paulo, UNIFESP, São Paulo, Brazil., Koch Nogueira PC; Department of Pediatric Kidney Transplantation, Hospital Samaritano de São Paulo, São Paulo, Brazil.; Department of Pediatrics, Federal University of São Paulo, UNIFESP, São Paulo, Brazil.
المصدر: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2022 May; Vol. 37 (5), pp. 1137-1147. Date of Electronic Publication: 2021 Oct 14.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 8708728 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-198X (Electronic) Linking ISSN: 0931041X NLM ISO Abbreviation: Pediatr Nephrol Subsets: MEDLINE
أسماء مطبوعة: Publication: Berlin : Springer International
Original Publication: Berlin : Springer International, c1987-
مواضيع طبية MeSH: Kidney Transplantation*/adverse effects , Thrombosis*/epidemiology , Thrombosis*/etiology, Adult ; Child ; Graft Rejection/epidemiology ; Graft Rejection/etiology ; Graft Survival ; Humans ; Kidney ; Living Donors ; Retrospective Studies ; Tissue Donors
مستخلص: Background: The use of small pediatric kidneys as single grafts for transplantation is controversial, due to the potential risk for graft thrombosis and insufficient nephron mass.
Methods: Aiming to test the benefits of transplanting these kidneys, 375 children who underwent kidney transplantation in a single center were evaluated: 49 (13.1%) received a single graft from a small pediatric donor (≤ 15 kg, SPD group), 244 (65.1%) from a bigger pediatric donor (> 15 kg, BPD group), and 82 (21.9%) from adult living donors (group ALD).
Results: Groups had similar baseline main characteristics. After 5 years of follow-up, children from the SPD group were comparable to children from BPD and ALD in patient survival (94%, 96%, and 98%, respectively, p = 0.423); graft survival (89%, 88%, and 93%, respectively, p = 0.426); the frequency of acute rejection (p = 0.998); the incidence of post-transplant lymphoproliferative disease (p = 0.671); the odds ratio for severely increased proteinuria (p = 0.357); the rates of vascular thrombosis (p = 0.846); and the necessity for post-transplant surgical intervention prior to discharge (p = 0.905). The longitudinal evolution of eGFR was not uniform among groups. The three groups presented a decrease in eGFR, but the slope of the curve was steeper in ALD children. At 5 years, the eGFR of the ALD group was 10 ml/min/1.73m 2 inferior to the others. At that time, the eGFR from the SPD group was statistically similar to the BPD group (p = 0.952).
Conclusion: In a specialized transplant center, the use of a single small pediatric donor kidney for transplantation is as successful as bigger pediatric or adult living donors, after 5 years of follow-up. A higher resolution version of the Graphical abstract is available as Supplementary information.
(© 2021. The Author(s), under exclusive licence to International Pediatric Nephrology Association.)
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فهرسة مساهمة: Keywords: Kidney transplantation; Organ allocation; Pediatrics; Small donor
تواريخ الأحداث: Date Created: 20211015 Date Completed: 20220425 Latest Revision: 20230413
رمز التحديث: 20231215
DOI: 10.1007/s00467-021-05296-1
PMID: 34651246
قاعدة البيانات: MEDLINE
الوصف
تدمد:1432-198X
DOI:10.1007/s00467-021-05296-1