ABSTRACT
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.
Subject(s)
Kidney Transplantation/methods , Adult , Age Factors , Child , Child, Preschool , Female , Graft Survival , Humans , Immunosuppressive Agents/therapeutic use , Infant , Kaplan-Meier Estimate , Male , Middle Aged , Postoperative Complications/epidemiology , Retrospective Studies , Spain , Survival Analysis , Tissue Donors , Tissue and Organ Procurement , Treatment OutcomeABSTRACT
OBJETIVOS: Análisis evolutivo de los trasplantes renales realizados con órganos procedentes de donantes infantiles implantados en bloque a receptores adultos. METODOS: Análisis retrospectivo de 73 trasplantes renales en bloque y 497 trasplantes adultos realizados en nuestro centro entre 1990 y 2004. El seguimiento medio fue de 50,23 meses (10,18-89,05 meses). Todos los pacientes recibieron la misma terapia inmunosupresora, si bien ésta evolucionó con el tiempo. RESULTADOS: Se objetivaron diferencias en cuanto a la no función y la disfunción inicial del injerto que fueron mayores en los bloques pediátricos y los trasplantes adultos, respectivamente. Los bloques ocasionan mejor función renal y menor proteinuria. Las supervivencias del paciente y del injerto fueron similares en ambos grupos. Las supervivencias del injerto al año y 5 años fueron del 83,56 % y 81,47 % en los trasplantes de riñones infantiles en bloque; y del 91,50 % y 86,99 % en los trasplantes de riñones procedentes de donantes adultos. Las complicaciones vasculares son la causa más común de pérdida del injerto en bloque. CONCLUSIONES: Los bloques pediátricos presentan una excelente supervivencia y función a medio y largo plazo. Las complicaciones vasculares representan la principal causa de pérdida del injerto pediátrico. La adopción de un programa de trasplante infantil en bloque permite aumentar la actividad trasplantadora (AU)
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 (AU)
