Paediatric kidney transplants from donors aged 1 year and under: an analysis of the Australian and New Zealand Dialysis and Transplant Registry from 1963 to 2018

Jinna Yao; Philip A Clayton; Kate Wyburn; Harsham Choksi; Elena Cavazzoni; David Tovmassian; Howard M H Lau; Richard Allen; Lawrence Yuen; Jerome M Laurence; Vincent W T Lam; Henry C C Pleass

doi:10.1111/tri.13772

Paediatric kidney transplants from donors aged 1 year and under: an analysis of the Australian and New Zealand Dialysis and Transplant Registry from 1963 to 2018

Transpl Int. 2021 Jan;34(1):118-126. doi: 10.1111/tri.13772. Epub 2020 Nov 9.

Authors

Jinna Yao^{1

2

3}, Philip A Clayton^{4

5

6}, Kate Wyburn^{3

7}, Harsham Choksi³, Elena Cavazzoni^{8

9}, David Tovmassian¹, Howard M H Lau^{1

10

11}, Richard Allen^{1

3}, Lawrence Yuen^{1

3}, Jerome M Laurence^{3

12}, Vincent W T Lam^{1

10}, Henry C C Pleass^{1

3}

Affiliations

¹ National Pancreas Transplant Unit, Westmead Hospital, Sydney, NSW, Australia.
² Department of Urology, Westmead Hospital, Sydney, NSW, Australia.
³ Faculty of Medicine and Health, University of Sydney Medical School, Camperdown, NSW, Australia.
⁴ Department of Medicine, The University of Adelaide, Adelaide, SA, Australia.
⁵ Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.
⁶ Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, SA, Australia.
⁷ Department of Renal Medicine, Royal Prince Alfred Hospital, Sydney, NSW, Australia.
⁸ NSW Organ and Tissue Donation Service, Sydney, NSW, Australia.
⁹ Paediatric Intensive Care Unit, The Children's Hospital at Westmead, Sydney, NSW, Australia.
¹⁰ Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia.
¹¹ School of Medicine, Western Sydney University, Sydney, Australia.
¹² Department of Surgery, Royal Prince Alfred Hospital, Sydney, NSW, Australia.

PMID: 33067898
DOI: 10.1111/tri.13772

Abstract

Kidneys from very small donors have the potential to significantly expand the donor pool. We describe the collective experience of transplantation using kidneys from donors aged ≤1 year in Australian and New Zealand. The ANZDATA registry was analysed on all deceased donor kidney transplants from donors aged ≤1 year. We compared recipient characteristics and outcomes between 1963-1999 and 2000-2018. From 1963 to 1999, 16 transplants were performed [9 (56%) adults, 7 (44%) children]. Death-censored graft survival was 50% and 43% at 1 and 5 years, respectively. Patient survival was 90% and 87% at 1 and 5 years, respectively. From 2000 to 2018, 26 transplants were performed [25 (96%) adults, 1 (4%) children]. Mean creatinine was 73 µmol/l ±49.1 at 5 years. Death-censored graft survival was 85% at 1 and 5 years. Patient survival was 100% at 1 and 5 years. Thrombosis was the cause of graft loss in 12% of recipients in the first era from 1963 to 1999, and 8% of recipients in the second era from 2000 to 2018. We advocate the judicious use of these small paediatric grafts from donors ≤1 year old. Optimal selection of donor and recipients may lead to greater acceptance and success of transplantation from very young donors.

Keywords: en bloc transplant; infant donors; kidney transplant; organ procurement; paediatric donor; surgical complications.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Australia
Child
Graft Survival
Humans
Infant
Kidney Transplantation*
New Zealand
Registries
Renal Dialysis
Tissue Donors