AUTHOR=Spaggiari Mario , Petrochenkov Egor , Patel Hiteshi , Di Cocco Pierpaolo , Almario-Alvarez Jorge , Fratti Alberto , Tzvetanov Ivo , Benedetti Enrico 

TITLE=Donor Size Doesn’t Impact En Bloc Kidney Transplant Outcomes: A Single-Center Experience and Review of Literature

JOURNAL=Transplant International

VOLUME=Volume 35 - 2022

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10731

DOI=10.3389/ti.2022.10731

ISSN=1432-2277

ABSTRACT=Background: Few transplant programs use kidneys from donors with body weight (BW) <10 kg. Perceived concerns are related to higher incidence of vascular and urological complications, rejection, and DGF with en bloc kidneys grafts from small donors. The purpose of this study was to investigate the non-inferiority of pediatric en bloc kidneys from donors with BW<10 kg in comparison to heavier piers.  

Methods: We performed a single-center retrospective analysis of en bloc kidney transplants from pediatric donor cohort (n=46) from 2003 to 2021 and stratified the outcomes by donor BW (small group, donor BW<10 kg, n = 30; standard group, donor BW>10 kg, n=16). Renal graft function, rate of early post-transplant complications, graft and patient survival were analyzed. 

Results: Complication rates were similar between both groups with 1 case of arterial thrombosis in the smaller group. After mean follow-up of 51 months (smaller donors) and 89 months (standard donors), overall graft and patient survival rates were similar between the small and the standard group (graft survival - 90% vs 100%, P = 0.09; patient survival - 96.7 vs 100%, P = 0.48). Serum creatinine at 1, 3, and 5 years was no different between groups. Reoperation rate was higher in the small group (23.3% vs 6.25%, P=0.03). 

Conclusions: The renal allograft from small donors could be related to higher reoperation rate in the early post-transplant period. However, utilization of en bloc kidney transplants from donors with BW < 10 kg was not associated with lower long-term graft and patient survival.