Kidney and bladder health

21 August 2009

One small kidney does the job

An adult who receives a single kidney from a donor younger than five will fare just as well as an adult who receives kidneys from an older child, new research shows.

An adult who receives a single kidney from a donor younger than 5 years old is likely to fare just as well in the long run as an adult who receives kidneys from older children, new research shows.

If a kidney donor is younger than five years and the recipient is an adult, both kidneys are usually transplanted based on the belief that one small kidney would not be sufficient in an adult, the researchers, all from the Tulane Abdominal Transplant Institute, New Orleans, explain in a report posted online Thursday.

Also, Dr. Sander Florman told Reuters Health, "Technically it's very challenging to 'split' the kidneys from these babies. It's so difficult that some programs don't even use them en bloc - they're just thrown away. So this is a great way to use organs that wouldn't otherwise be used."

Size doesn't matter
Florman and associates compared the outcomes of 40 adult recipients of single kidneys from donors younger than age five and 39 adult recipients of kidneys from donors aged 5 to 10 years.

As expected, the kidneys in the younger donor group were significantly smaller than those in the older donor group.

And while ureteral stents - tubes inserted to help drain urine from the kidney - were required more often in the younger donor group (73 percent versus 38 percent), complications that required additional surgery were similar in the two groups.

Results of transplants similar
Moreover, patients in the two groups experienced similar rates of kidney rejection and delayed kidney function.

In both groups, kidney function improved significantly in the first year after transplant, and continued to improve into the third year post-transplant. Furthermore, patients in the two groups lived a similar length of time.

"Single paediatric kidney transplants from donors who are younger than five years can be used with acceptable complications and good long-term outcomes as those from older pediatric donors," Florman and colleagues conclude.

"By now we've done more than 120 of these cases," Florman said. "It's not saving the world...but at least we're helping more patients to get kidney transplants."

A statement from the American Society of Nephrology points out that roughly 80,000 people in the US are waiting for kidney transplants. (Reuters Health, August 2009) (Reference: Clinical Journal of the American Society of Nephrology 2009.)


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