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Grandparent donors in paediatric renal transplantation

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Abstract

The outcome of transplantation from grandparent donors in comparison with parental donors in paediatric renal transplantation was evaluated in 53 living related donor (LRD) transplantations performed between January 1996 and August 2003. The donor in 13 cases (25%) was a grandparent (Gpar group), and the remaining donors formed the parent group (Par group). The median age of recipients in the Gpar group was 2.75 (1.7–10.6) years and in the Par group was 12.75 (2.4–22) years (P<0.0001). There was no evidence of a difference in patient and graft survival, glomerular filtration rate (GFR) after transplantation, or the number of biopsy proven episodes of rejection between the groups. Doses of prednisolone in the first year following transplantation were greater in recipients from Gpar donors, but the other immunosuppression doses were similar. The median age of donors in the Gpar group was 56 (50–67) years and in the Par group was 41 (27–58) years (P<0.0001). There was no evidence of a difference between the two donor groups in mean creatinine clearance at last follow-up. There were two major donor complications in the Gpar group and one in the Par group. There was no evidence that the length of stay differed between the two groups in either the donors or recipients. These results support the use of carefully selected healthy grandparents as LRDs in children. This option potentially allows for the use of parent donors for a subsequent transplantation.

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References

  1. Adams J, Tonshoff B, Staehler G, Wiesel M (2001) Influence of donor’s age on graft survival in renal transplanted children. Transplant Proc 33:2973–2974

    Article  PubMed  Google Scholar 

  2. Schurman SJ, McEnery PT (1997) Factors influencing short-term and long-term pediatric renal transplant survival. J Pediatr 130:455–462

    PubMed  Google Scholar 

  3. Cohn RA (2001) Pediatric kidney transplants—-who shall donate? Pediatr Transplant 5:145–147

    Article  PubMed  Google Scholar 

  4. Davis ID, Bunchman TE, Grimm PC, Benfield MR, Briscoe DM, Harmon WE, Alexander SR, Avner ED (1998) Pediatric renal transplantation: indications and special considerations. A position paper from the Pediatric Committee of the American Society of Transplant Physicians. Pediatr Transplant 2:117–129

    PubMed  Google Scholar 

  5. De Meester J, Smits JM, Offner G, Persijn GG (2001) Renal retransplantation of children: is a policy ‘first cadaver donor, then live donor’ an acceptable option? Pediatr Transplant 5:179–186

    Article  PubMed  Google Scholar 

  6. Hardy B, Cicciarelli JC, Iwaki Y, Shaul D, Mendez R (1994) Effect of donor age on graft survival rates in pediatric living related transplants, first cadaver transplants, and regrafts. Transplant Proc 26:44–45

    PubMed  Google Scholar 

  7. Ishitani M, Isaacs R, Norwood V, Nock S, Lobo P (2000) Predictors of graft survival in pediatric living-related kidney transplant recipients. Transplantation 70:288–292

    Article  PubMed  Google Scholar 

  8. Kalicinski P, Grenda R, Smirska E, Kaminski A, Prokurat A (1996) Living-related donor kidney transplantation in children: Child’s Health Center Memorial Hospital experience. Transplant Proc 28:3575

    PubMed  Google Scholar 

  9. Nyberg SL, Manivel JC, Cook ME, Gillingham KJ, Matas AJ, Najarian JS (1997) Grandparent donors in a living related renal transplant program. Clin Transplant 11:349–353

    PubMed  Google Scholar 

  10. Haberal M, Karakayali H, Moray G, Demirag A, Yildirim S, Bilgin N (1998) Long-term follow-up of 102 living kidney donors. Clin Nephrol 50:232–235

    PubMed  Google Scholar 

  11. Tejani A, Sullivan EK (2000) Do six-antigen-matched cadaver donor kidneys provide better graft survival to children compared with one-haploidentical living-related donor transplants? A report of the North American Pediatric Renal Transplant Cooperative Study. Pediatr Transplant 4:140–145

    Article  PubMed  Google Scholar 

  12. Stryjecka-Rowinska D, Wataszewski J (1996) Kidney transplantation from living-related donors. Transplant Proc 28:3576–3577

    PubMed  Google Scholar 

  13. Kumar A, Verma BS, Srivastava A, Bhandari M, Gupta A, Sharma RK (2000) Long-term followup of elderly donors in a live related renal transplant program. J Urol 163:1654–1658

    Article  PubMed  Google Scholar 

  14. Sumrani N, Delaney V, Ding ZK, Davis R, Daskalakis P, Tejani A, Butt K, Hong J (1991) Renal transplantation from elderly living donors. Transplantation 51:305–309

    PubMed  Google Scholar 

  15. Kerr SR, Gillingham KJ, Johnson EM, Matas AJ (1999) Living donors >55 years: to use or not to use? Transplantation 67:999–1004

    Article  PubMed  Google Scholar 

  16. Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A (1976) A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 58:259–263

    PubMed  Google Scholar 

  17. Taylor CM (1994) Assessment of glomerular filtration rate. In: Postlethwaite RJ (ed) Clinical paediatric nephrology. Butterworth Heinemann, Oxford, pp 89–101

  18. Kockelbergh RC, Francis DMA, Millar RJ, Walker RG, Jones C, Becker G (1993) Appropriate allocation of pediatric donor kidneys. Clin Transpl 7:206–210

    Google Scholar 

  19. Francis DM, Millar RJ, Walker RG, d’Apice AJ, Clunie GJ (1989) Cadaver renal transplantation in children using low dose triple immunosuppression. Transplant Proc 21:1696–1697

    PubMed  Google Scholar 

  20. Francis DM, Walker RG, d’Apice AJ (1987) Low-dose triple immunosuppression in pediatric cadaveric renal transplantation. Transplant Proc 19:3677–3678

    PubMed  Google Scholar 

  21. Supabphol A, Francis DM, Millar RJ, Hutson J, Kelly J, Walker RG, Powell H, Jones CL (1995) Renal transplantation in very young children. Aust N Z J Surg 65:637–641

    Google Scholar 

  22. O’Connell P, d’Apice A, Walker R, Francis D, Kincaid-Smith P (1988) Cessation of steroids in renal allograft recipients on combined cyclosporine A, azathioprine, and prednisolone. Transplant Proc 20:11–13

    Google Scholar 

  23. Kausman JY, Powell HR, Jones CL (2004) Anemia in pediatric renal transplant recipients. Pediatr Nephrol 19:526–530

    Article  PubMed  Google Scholar 

  24. Field MJ, Pollock CA, Harris DC (2001) The renal system—basic science and clinical conditions, 1st edn. Churchill Livingstone, London, p 69

  25. Stata Statistical Software (2003) Stata Corporation, College Station, Texas

  26. Tanaka K, Kinukawa T, Matsuura O, Hattori R, Hirabayashi S, Sahashi M, Fujita T, Ono Y, Ohshima S (2000) The effect of donor age on living-related kidney transplantation. Transplant Proc 32:1583–1584

    Article  PubMed  Google Scholar 

  27. Singh AK, Sharma RK, Agrawal S, Avula S, Gupta A, Kumar A, Kapoor R, Bhandari M (1998) Long-term allograft survival in renal transplantation from elderly donors. Transplant Proc 30:3659

    Article  PubMed  Google Scholar 

  28. Degawa H, Nemoto T, Uchiyama M, Kozaki K, Matsuno N, Sakurai E, Kubota K, Kozaki M, Nagao T (1998) Effect of donor age on renal allograft survival. Transplant Proc 30:3660–3661

    Article  PubMed  Google Scholar 

  29. Hayashi T, Koga S, Higashi Y, Ohtomo Y, Satomura K, Mannami M (1995) Living-related renal transplantation from elderly donors (older than 66 years of age). Transplant Proc 27:984–985

    PubMed  Google Scholar 

  30. Kim YS, Kim SI, Suh JS, Park K (1992) Use of elderly living related donors in renal transplantation. Transplant Proc 24:1325–1326

    PubMed  Google Scholar 

  31. Levin A, Stevens LA (2005) Executing change in the management of chronic kidney disease: perspectives on guidelines and practice. Med Clin North Am 89:701–709

    Article  PubMed  Google Scholar 

  32. Johnson EM, Remucal MJ, Gillingham KJ, Dahms RA, Najarian JS, Matas AJ (1997) Complications and risks of living donor nephrectomy. Transplantation 64:1124–1128

    Article  PubMed  Google Scholar 

  33. Ojogho O, Sahney S, Cutler D, Abdelhalim F, Hasan M, Baron P, Concepcion W (2002) Superior long-term results of renal transplantation in children under 5 years of age. Am Surg 68:1115–1119

    PubMed  Google Scholar 

  34. Kohaut EC, Tejani A (1996) The 1994 annual report of the North American Pediatric Renal Transplant Cooperative Study. Pediatr Nephrol 10:422–434

    Article  PubMed  Google Scholar 

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Acknowledgements

This work was presented in abstract/poster form at The Thirteenth Congress of the International Paediatric Nephrology Association in Adelaide, Australia, in August 2004. We thank Suzanna Vidmar for statistical co-ordination and Ms Vicki Burns for her help with the manuscript submission.

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Authors and Affiliations

  1. Department of Nephrology, The Royal Children’s Hospital, Flemington Road, Parkville, Victoria 3052, Australia

    Catherine M. Simpson, Steven J. McTaggart, Rowan G. Walker, Harley R. Powell & Colin L. Jones

  2. Department of Social Medicine, University of Bristol, Bristol, UK

    Jonathan A. C. Sterne

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  1. Catherine M. Simpson
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  2. Steven J. McTaggart
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  3. Jonathan A. C. Sterne
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Correspondence to Catherine M. Simpson.

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Simpson, C.M., McTaggart, S.J., Sterne, J.A.C. et al. Grandparent donors in paediatric renal transplantation. Pediatr Nephrol 20, 1636–1641 (2005). https://doi.org/10.1007/s00467-005-2002-x

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  • DOI: https://doi.org/10.1007/s00467-005-2002-x

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