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En bloc paediatric kidney transplant: is this the best use of a scarce resource?

En bloc paediatric kidney transplant: is this the best use of a scarce resource?

Authors :
Lam, Vincent W. T.
Laurence, Jerome M.
Robertson, Paul
Hawthorne, Wayne
Ryan, Brendan J.
Lau, Howard M. H.
Allen, Richard D. M.
Pleass, Henry C. C.
Source :
ANZ Journal of Surgery; Jan/Feb2009, Vol. 79 Issue 1/2, p27-32, 6p, 2 Color Photographs, 1 Diagram, 1 Chart, 2 Graphs
Publication Year :
2009

Abstract

Background: Kidney transplants using organs from paediatric cadaver donors are uncommon and technically difficult. It has become accepted practice to transplant both kidneys en bloc from donors of 5 years into a single recipient. We aim to compare outcomes of en bloc kidney (EBK) transplants versus single kidney (SK) transplants from cadaver donors of age 5 years and lesser. Methods: Data reported to Australia and New Zealand Dialysis and Transplant Registry from 1989 to 2004 were analysed. Results: From donors 5 years of age and younger, there were 33 EBK and 38 SK transplants carried out. Overall graft survival rates at 1 and 5 years were 78 and 61%, respectively, in the EBK group and 63 and 55%, respectively, in the SK group ( P = 0.94). Vascular thrombosis was the most common cause of early graft loss with an incidence of 11 and 18%, respectively, in the EBK and SK groups ( P = 0.5). Conclusion: There is a trend towards a lower vascular thrombosis rate and a better long-term graft survival in EBK transplants. These transplants will remain a technical challenge for the surgeon and EBK transplants should remain the technique of choice for donors of 5 years and lesser. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
14451433
Volume :
79
Issue :
1/2
Database :
Complementary Index
Journal :
ANZ Journal of Surgery
Publication Type :
Academic Journal
Accession number :
36324089
Full Text :
https://doi.org/10.1111/j.1445-2197.2008.04793.x