Pediatric donor transplants to adult recipients: follow-up and outcome
Manuel Rengel1, Lorena Tana1, Facundo Humacata1, Almudena Vega1, Soraya Abad1, Úrsula Verdalles1, Eduardo Verde1.
1Nephrology, Hospital General Universitario "Gregorio Marañón", Madrid, Spain
Introduction: The use of kidneys from pediatric donors, neonates in adults, is an option considered possible in teams dedicated to kidney transplantation. We present our experience with transplantation of separately kidneys from i neonatal donors implanted in adult recipients.
Patients: Four adult patients aged 25 to 35 years were transplanted with kidneys from neonatal donors, less than 1 year old, with the usual technique. They received immunosuppression with Cyclosorine, Azathioprine and Prednisone.
Results: During the first 15 days it was necessary to practice hemodialysis. From then on, the renal function of the graft improved until plasma creatinine of 1.7±0.5 mg/dl was reached. After the first year of follow-up, creatinine stabilized at around 1 mg/dl. In the first 3 - 4 weeks the graft reached the size of an adult kidney, controlled by ultrasound. These patients, after 25 years, keep the graft functioning, with plasma creatinine less than 1 mg/dl. They do not have high blood pressure and have not had acute rejection.
Conclusion: Kidneys from child donors can be grafted in isolation with excellent results. Only technical-surgical reasons can prevent the use of organs from donors under 1 year of age. The result in our hands with this type of donor shows us that it is possible to use it.
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