1Division of Transplant Surgery, Department of Surgery, New York-Presbyterian Hospital, Weill Medical College of Cornell University, New York, NY, USA.
Transplantation. 2010 Sep 15;90(5):518-22. doi: 10.1097/TP.0b013e3181e98d35.
The outcomes of single kidneys transplanted from pediatric donors into standard adult recipients (>60 kg) are unknown. Furthermore, the outcomes of single kidneys transplanted from pediatric donors less than or equal to 10 kg are also unknown.
We retrospectively compared 27 recipients of single kidneys from pediatric donors younger than or equal to 5 years with 69 recipients of adult cadaveric kidneys.
The mean pediatric kidney recipient weight was 69 kg. Two-year patient and graft survival in pediatric kidney recipients was 100% and 92.5% respectively, compared with 98.5% and 89.8% in adult kidney recipients (P=NS). Mean time (days) to achieve creatinine less than 3 mg/dL was 14+/-9 compared with 14+/-20 in adult kidney recipients (P=NS). Estimated glomerular filtration rate at discharge, 6, 12, 18, and 24 months was equivalent in both cohorts. Stratifying pediatric kidney recipients by donor weight, there were no differences in acute rejection or graft loss in recipients of kidney from donors less than or equal to 10 kg (n=11; mean weight=8.85 kg), but there was a higher incidence of delayed graft function (7 of 11 vs. 1 of 16; P=0.002). Estimated glomerular filtration rate at discharge, 6, 12, 18, and 24 months was equivalent in both cohorts.
Single pediatric kidneys from donors younger than or equal to 5 years can be transplanted into standard adult recipients without compromising outcomes. Transplanting single kidneys from pediatric donors less than or equal to 10 kg into standard adult recipients is associated with an increased risk of delayed graft function; however, this does not compromise 2-year graft survival or function.
从儿科供体移植到标准成人受者（>60 公斤）的单肾的结果尚不清楚。此外，从体重等于或小于 10 公斤的儿科供体移植的单肾的结果也尚不清楚。
我们回顾性比较了 27 名体重等于或小于 5 岁的儿科供体单肾受者和 69 名成人尸体供体肾受者。
儿科供体肾受者的平均体重为 69 公斤。2 年时，儿科供体肾受者的患者和移植物存活率分别为 100%和 92.5%，而成人供体肾受者的患者和移植物存活率分别为 98.5%和 89.8%（P=NS）。达到肌酐<3mg/dL 的平均时间（天）为 14+/-9 天，而成人供体肾受者为 14+/-20 天（P=NS）。出院时、6、12、18 和 24 个月的估计肾小球滤过率在两组中相等。在儿科供体肾受者中按供体体重分层，体重等于或小于 10 公斤的供体的肾移植受者中，急性排斥反应或移植物丢失无差异（n=11；平均体重=8.85 公斤），但延迟移植物功能（7/11 比 1/16；P=0.002）的发生率较高。出院时、6、12、18 和 24 个月的估计肾小球滤过率在两组中相等。
从 5 岁或以下的儿科供体移植的单肾可以移植到标准的成人受者而不影响结果。将体重等于或小于 10 公斤的儿科供体的单肾移植到标准的成人受者中与延迟移植物功能的风险增加相关；然而，这并不影响 2 年的移植物存活率或功能。
