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NDT Advance Access published online on March 24, 2007
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfm080
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

A prospective study on size and function of paediatric kidneys (<10 years) transplanted to adults

Aksel Foss1, Pål-Dag Line1, Knut Brabrand2, Karsten Midtvedt3 and Anders Hartmann3

1Surgical Department, Section of Transplant Surgery, 2Department of Radiology and 3Medical Department, Section of Nephrology, Rikshospitalet-Radiumhospitalet University Hospital, Oslo, Norway.

Correspondence and offprint requests to: Aksel Fossl, Department of Surgery, Section of Transplant Surgery, Rikshospitalet, N-0027 Oslo, Norway. Email: akselfoss{at}rikshospitalet.no



  Abstract

Background. There is increasing evidence that paediatric kidneys transplanted to adults have good graft function and satisfactory graft survival. The relationship between size increment and functional potential of paediatric kidneys following transplantation is not defined in detail. We therefore initiated a prospective single centre study, comprising detailed and repeated measurements of size and function of paediatric kidneys transplanted to adults.

Methods. Nineteen adults receiving a first kidney transplant from a paediatric donor (<10 years of age) were included in the study. All patients were followed for 12 months post-transplant. Increment in size and function of the transplanted kidneys were assessed by ultrasound, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). All tests were performed during the first week, post-transplant and subsequently repeated at 1, 3, 6 and 12 months.

Results. Kidney volume increased 2.6-fold at 12 months (P < 0.001). GFR and ERPF showed a slightly more moderate increase, 1.8-fold and 1.6-fold, respectively. Patient and graft survival at 1 year were 100% and serum creatinine was 91 µmol/l (66–169).

Conclusion. The study indicates that paediatric kidneys for transplantation may be considered as excellent rather than being referred to as suboptimal for adult recipients, at least the first year after transplantation.

Keywords: kidney size; kidney transplantation; paediatric donors; transplant function

Received for publication: 6.11.06
Accepted in revised form: 26. 1.07


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