Nephrology Dialysis Transplantation, Vol 13, Issue 6 1494-1498, Copyright © 1998 by Oxford University Press
L Dubourg, A Hadj-Aissa, B Parchoux, M Dawahra, X Martin, L David, N Pozet and P Cochat
Background: The donor, i.e. adult or paediatric, might
influence the outcome of the graft function. Methods:
The glomerular filtration rate (GFR) of 120 transplanted children (47
girls) aged 10.4±4.6 years (0.7-17.2) was prospectively assessed
over a 5-year period. The patients were divided into two groups according
to the age of donor: adult (donor age >18 years; n=33) and
paediatric (donor age <18 years; n=87). GFR was assessed by inulin
clearance at 3, 6 and 12 months and yearly thereafter.
Results: The average GFR was stable in the range of 70
ml/min/1.73 m2 for the whole follow-up period. The
adjusted GFR in adult graft recipients was significantly higher at 3 months
post-transplantation: 80.6±36.9 vs
65.1±22.0, P=0.02. However, from the second year
post-transplantation, the adjusted GFR in paediatric graft recipients
became significantly higher than that of adult graft recipients. Such
results could be due to an improvement in the absolute GFR (ml/min) of
paediatric graft recipients with time (P=0.0001) whereas that of the adult
graft recipients remained stable despite the children's growth.
Conclusions: The adjusted GFR of adult graft
recipients was significantly higher than that of paediatric graft
recipients in the early post transplant period. In the long-term, a
progressive decrease in adjusted GFR was noted in adult graft recipients.
On the one hand, this may be due to a functional adaptation and/or
inadequate compensatory growth of the graft. On the other hand, the
absolute GFR of paediatric graft recipients increased, suggesting an
ongoing capacity for growth and/or compensatory hypertrophy after
child-to-child renal transplantation. Key words: adult
donor; paediatric donor; paediatric renal transplantation; renal function;
renal functional adaptations
ORIGINAL ARTICLES
Role of the donor in post-transplant renal function
Département de Pédiatric, Service d'Exploration Fonctionelle Rénale and Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot and Université Claude Bernard, Lyon, France; Corresponding author at: Unité de Néphrologie Pédiatrique, Hôpital Edouard Herriot, F-6937 Lyon cedex 03, France
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