ESPU Congress 2018 - Abstract Book

129

11–14 APRIL, 2018, HELSINKI, FINLAND

13:33–13:36

S16-2 (PP)

OUTCOME OF KIDNEY TRANSPLANTATION FROM YOUNG

PEDIATRIC DONORS (AGED LESS THAN 6 YEARS)

TO YOUNG SIZE-MATCHED RECIPIENTS

Romy GANDER

, Marino ASENSIO

, José Andrés MOLINO

, Gloria Fatou ROYO

Montserrat AGUILERA PUJABET

, Luis Enrique LARA

, Gema ARICETA

and Manuel

LOPEZ

1) University Hospital Vall d'Hebron. Barcelona, Pediatric Surgery. Pediatric Urology and Renal Transplant Unit,

Barcelona, SPAIN - 2) University Hospital Vall d'Hebron. Barcelona, Pediatric Surgery. Renal Transplant Unit, Barcelona,

SPAIN - 3) University Hospital Vall d'Hebron Barcelona, Pediatric Surgery, Barcelona, SPAIN - 4) University Hospital Vall

d'Hebron Barcelona, Pediatric nephrology, Barcelona, SPAIN

PURPOSE

Pediatric donation is underutilized due to presumed increased risk of vascular thrombosis (VT) and

graft loss. Using young pediatric donors (YPD) for young pediatric recipients (YPR) is suggested

to be even at greater risk and therefore precluded in many centers. The aim of this study was to

analize the outcome of Kidney Transplantation (KT) from YPD to age-matched YPR.

MATERIAL AND METHODS

Retrospective study of 118 pediatric KT performed between January 2007–July 2017. We identified

KT with YPD (considered as those aged <6 years) and age-matched YPR. Data were collected

regarding donor and recipients characteristics, surgical and urological complications, graft loss and

outcomes.

RESULTS

Forty cases were identified (33.89 %). Mean recipient and donor age was 2.9 years (SD:1.68) and

2.24 years (SD: 1.5), respectively. Mean recipient and donor weight was 12.7 kg (SD: 4.1) and

13.7 kg (SD:4.15), respectively. Thirty (75 %) recipients weighed <15 kg. The most frequent primary

renal disease was congenital nephrotic syndrome (13). Nine (22.5 %) had received a previous KT.

Three received a combined liver-KT. Eight (20 %) were at high immunological risk and 19 (47.5 %)

at high thrombotic risk.

All allografts were implanted extraperitoneally. Major complications requiring reintervention ap-

peared in 7 (17.5 %): 3 VT, 3 bleedings and 1 ureteral necrosis. Remarkably, only 1 surgical com-

plication (VT) was related to graft loss. Regarding to long-term urological complications, 4 (10 %)

developed VUR to the graft (all had underlying uropathy).

As a whole 8 patients lost their graft (20 %). Actuarial graft survival at 1,5–10 years was

83 %–78 %–78 %, respectively. Mean follow-up was 49 months (SD:38.8).

CONCLUSIONS

We suggest that KT using YPD for age-match YPR yields good results, even in high-risk patients

and is associated with good graft survival. In our series, surgical complications were rarely related

to graft loss.