Priority Should be Given to Centers that Split En Bloc Pediatric Kidneys to Maximize Transplantation: A Single Center Experience

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-01-30 DOI:10.1016/j.transproceed.2025.01.004

Daniel Barbash , Miriam Steinberger , Julia Torabi , Hillary Yaffe , Maria Ajaimy , Enver Akalin , Luz E. Liriano , Yorg Azzi , Swati Jain , Cindy Pynadath , Nidal Muhdi , Marie Le , Jay A. Graham

{"title":"Priority Should be Given to Centers that Split En Bloc Pediatric Kidneys to Maximize Transplantation: A Single Center Experience","authors":"Daniel Barbash , Miriam Steinberger , Julia Torabi , Hillary Yaffe , Maria Ajaimy , Enver Akalin , Luz E. Liriano , Yorg Azzi , Swati Jain , Cindy Pynadath , Nidal Muhdi , Marie Le , Jay A. Graham","doi":"10.1016/j.transproceed.2025.01.004","DOIUrl":null,"url":null,"abstract":"<div><div>The foundation for OPTN policy 8.5.B that allows for en bloc kidney utilization from pediatric donors under <18 kg is unclear. Naturally, kidneys recovered from these donors can be split and transplanted into 2 adult recipients as opposed to only 1 (OPTN policy 8.5.C). Our center universally splits all pediatric donor kidneys. We showed that early eGFR is lower in recipients that receive a kidney from a donor <18 kg (3-month eGFR; 36.3 vs 49.7 mL/min/1.73 m<sup>2</sup>, <em>P</em> = .01), but quickly rebounds with no significant differences thereafter. As such, efforts should be made to revisit the practice of en bloc kidney transplantation from small pediatric donors. Given similar complication rates and outcomes seen at our center between the 2 groups, “splitting first” should be the policy to ensure maximalization of transplant recipients.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 2","pages":"Pages 250-254"},"PeriodicalIF":0.8000,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation proceedings","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0041134525000077","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"IMMUNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

The foundation for OPTN policy 8.5.B that allows for en bloc kidney utilization from pediatric donors under <18 kg is unclear. Naturally, kidneys recovered from these donors can be split and transplanted into 2 adult recipients as opposed to only 1 (OPTN policy 8.5.C). Our center universally splits all pediatric donor kidneys. We showed that early eGFR is lower in recipients that receive a kidney from a donor <18 kg (3-month eGFR; 36.3 vs 49.7 mL/min/1.73 m², P = .01), but quickly rebounds with no significant differences thereafter. As such, efforts should be made to revisit the practice of en bloc kidney transplantation from small pediatric donors. Given similar complication rates and outcomes seen at our center between the 2 groups, “splitting first” should be the policy to ensure maximalization of transplant recipients.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.