Single vs dual (en bloc) kidney transplants from donors ≤ 5 years of age: A single center experience.

Autor:	Al-Shraideh Y; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Farooq U; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., El-Hennawy H; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Farney AC; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Palanisamy A; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Rogers J; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Orlando G; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Khan M; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Reeves-Daniel A; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Doares W; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Kaczmorski S; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Gautreaux MD; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Iskandar SS; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Hairston G; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Brim E; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Mangus M; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States., Stratta RJ; Yousef Al-Shraideh, Umar Farooq, Hany El-Hennawy, Alan C Farney, Jeffrey Rogers, Giuseppe Orlando, Muhammad Khan, Gloria Hairston, Elizabeth Brim, Margaret Mangus, Robert J Stratta, Department of Surgery, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States.
Jazyk:	angličtina
Zdroj:	World journal of transplantation [World J Transplant] 2016 Mar 24; Vol. 6 (1), pp. 239-48.
DOI:	10.5500/wjt.v6.i1.239
Abstrakt:	Aim: To compare outcomes between single and dual en bloc (EB) kidney transplants (KT) from small pediatric donors. Methods: Monocentric nonprospective review of KTs from pediatric donors ≤ 5 years of age. Dual EB KT was defined as keeping both donor kidneys attached to the inferior vena cava and aorta, which were then used as venous and arterial conduits for the subsequent transplant into a single recipient. Donor age was less useful than either donor weight or kidney size in decision-making for kidney utilization as kidneys from donors < 8 kg or kidneys < 6 cm in length were not transplanted. Post-transplant management strategies were standardized in all patients. Results: From 2002-2015, 59 KTs were performed including 34 dual EB and 25 single KTs. Mean age of donors (17 mo vs 38 mo, P < 0.001), mean weight (11.0 kg vs 17.4 kg, P = 0.046) and male donors (50% vs 84%, P = 0.01) were lower in the dual EB compared to the single KT group, respectively. Mean cold ischemia time (21 h), kidney donor profile index (KDPI; 73% vs 62%) and levels of serum creatinine (SCr, 0.37 mg/dL vs 0.49 mg/dL, all P = NS) were comparable in the dual EB and single KT groups, respectively. Actuarial graft and patient survival rates at 5-years follow-up were comparable. There was one case of thrombosis resulting in graft loss in each group. Delayed graft function incidence (12% dual EB vs 20% single KT, P = NS) was slightly lower in dual EB KT recipients. Initial duration of hospital stay (mean 5.4 d vs 5.6 d) and the one-year incidences of acute rejection (6% vs 16%), operative complications (3% vs 4%), and major infection were comparable in the dual EB and single KT groups, respectively (all P = NS). Mean 12 mo SCr and abbreviated MDRD levels were 1.17 mg/dL vs 1.35 mg/dL and 72.5 mL/min per 1.73 m(2) vs 60.5 mL/min per 1.73 m(2) (both P = NS) in the dual EB and single KT groups, respectively. Conclusion: By transplanting kidneys from young pediatric donors into adult recipients, one can effectively expand the limited donor pool and achieve excellent medium-term outcomes.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu