Korean J Transplant.  2022 Nov;36(Supple 1):S212. 10.4285/ATW2022.F-3506.

Split kidney transplant from pediatric donor less than 18kg: 5-year single-center outcome analysis

• Panjathia A
• Sharma A
• Sharma A
• Kanwar DB
• Singh S
• Kumar S

• KMID: 2535277
• DOI: http://doi.org/10.4285/ATW2022.F-3506

Abstract

Background
As demand has outpaced the supply of organs. Pediatric split kidney donors are now looked as a potential source of good quality organs at par with adult diseased donors and living kidney donors and en bloc pediatric kidney donors.
Methods
A single-center retrospective cohort study was done from August 2017 to August 2022, Total number of transplants done were 922 and out of which deceased donor were 233, during the study period. Fourteen split kidneys from seven pediat-ric donors weighing less than 18 kg were transplanted into recipients which were free from any comorbidities. Patients' data were retrieved from an electronic database, telegram, case file, and outpatient department follow-up in the department of renal transplant surgery PGIMER.
Results
The male and female recipients were (11:3). The mean (standard deviation [SD]) age of donors was 3.4 (1.1) years and recipients 27.7 (9.9) years. The mean (SD) estimated glomerular filtration rate (eGFR), increased steadily from 58 (31.8) mL/min/1.73 m ² at the time of discharge to 116 (24.8) mL/min/1.73 m² at end of 12 months. The mean (SD) eGFR remained sta-ble at 24– and 36 months posttransplant with the decrease in mean (SD) eGFR to 104 (17) mL/min/1.73 m² at mean follows up of 31 (23.5) months. Rejection was noticed in 1/14 transplant recipients and 1/14 had DGF. No vascular and urinary complica-tions were seen in any of the patients. 6/14 patients (42.8%) had covid infection posttransplant, 3/14 patients (21.4) had urinary tract infection and 2/14 patients (14.2) had surgical site infection.
Conclusions
Split pediatric kidneys can contribute to the organ donor pool with good outcomes and robust graft function in long term but are associated with manageable adverse outcomes in short term and the technical difficulties can be dealt with good surgical skills of the operating transplant surgeon