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S6: RENAL TRANSPLANTATION
Moderators: Wouter Feitz (Netherlands), Armando Lorenzo (Canada)
ESPU Meeting on Thursday 15, October 2015, 10:06 - 10:36
10:06 - 10:09
S6-1
(PP)
★
LONG-TERM OUTCOMES ADULT SIZE KIDNEYS IN SMALL PAEDIATRIC RENAL
TRANSPLANTATION
Maria Jose MARTINEZ-URRUTIA
1
, Roberto LOBATO
2
, Shirley MONSALVE
2
, Alba SANCHEZ
2
, Pedro LOPEZ PEREIRA
2
,
Susana RIVAS
2
and Carlota FERNANDEZ
3
1) La Paz Childrens Hospital, Paediatric Urology, Madrid, SPAIN - 2) Hospital La Paz, Urología Pediátrica, Madrid, SPAIN -
3) Hospital La Paz, Nefrología Pediátrica, Madrid, SPAIN
PURPOSE
The use of adult size kidney seems applicable to low-weight children where age and size-matched donors are so scarce.
The purpose is to assess the impact of donor-recipient size mismatched on long-term renal graft survival in small
recipient and optimize graft allocation.
MATERIAL AND METHODS
Between 1999 and 2010, 46 renal transplants were performed in recipient under 20 kg. Patients were stratified in two
groups according to donor-recipient size: (A) 19 adult-size graft and (B) 27 size-matched graft. All transplantation was
performed with similar surgery protocol and the same immunosuppressive regimen was employed.
Renal size, GFR and graft survival were analyzed and compared between two groups at one-two-five-yrs, and at the end
of the study. Proteinuria and acute rejection episodes also were reviewed.
RESULTS
The mean renal size was significantly different during the 1st-yr between both groups (A) 11.2±106 cm and (B) 8.6±0.8
cm, at five-yr the renal size from B increased (11.1±96 cm), but A did not change. The mean GFR (ml/min/1.73m2)
was 148±47 (A) and 111±33 (B) at the beginning, at one-yr decreased in A (127±38) and increased in B (121±31), at
five-yrs GFR was similar in both groups. During the mean follow-up (8.1 yrs) nine grafts were lost, two (A) and seven
(B). Two patients died (B). No significant differences were observed in graft survival at one-five and ten-yrs. Neither
proteinuria nor rejection.
CONCLUSIONS
Adult size kidneys in small recipients show a reduction of the function, but remain stable size. They can be safely
transplanted with comparable outcomes to size-matched grafts.