[Kidney transplantation from paediatric cadaveric donors to adult recipients (review article)].

Abstract

The basic problem of all developed transplant programs is organs deficiency available for transplantation. There is an effort within last 10 years to get each organ for transplantation that it is supposed to be functional for several years. These problems also occur in the program of kidney transplantation. Apart from realizing of kidney transplantations from donors alive, which have an increasing tendency in Czech Republic (in 2001 more than 5%, in 2002 more than 10%), there is the only another possibility to get kidney grafts from non-ideal (suboptimal, marginal) donors. Both short-term and long-term results of kidney transplantation from non-ideal donors are comparable with the transplantation results from ideal donors. The kidneys from very young paediatric cadaveric donors, especially up to five years are the typical example of non-ideal graft. The article introduces the international position of the Czech Republic in organ procurement from cadaveric donors as well as in kidney transplantations. It shortly summarizes the history of kidney transplantations and at the same time it deals with realizing of kidney transplantation from paediatric cadaveric donors to adult recipients. The new division of kidney grafts from paediatric cadaveric donors into four groups according to their age is introduced. All at once the present surgical technique is described and the problems of some post-operative complications are discussed, especially the higher occurrence of primary graft non-function. The principle that kidneys from donor up to three years should be transplanted as a block to the single recipient is emphasized. In conclusion the author recommends, on the basis of his own experiences, the realizing of these transplantations.