Impact and Application of Donor/Recipient Body Surface Area on Kidney Transplantation from Pediatric Donor to Adult Recipient.

BACKGROUND: Insufficient nephron dosing is closely associated with poor graft function and graft loss. Donor/recipient body surface area (D/R BSA) has been proven to be one of the useful predictors for sufficient nephron dosing. However, little is known regarding the impact and application of D/R BSA on kidney transplantation from pediatric donor to adult recipient.

METHODS: We retrospectively analyzed 26 cases of kidney transplantations from pediatric donors to adult recipients, which were performed in our center from 2010 through 2014. Patients were divided into 2 groups based on D/R BSA: group A, <0.8; and group B, ≥0.8. All recipients received a single kidney. Demographics of donors and recipients, early postoperative complications, estimated glomerular filtration rate (eGFR), and short-term (≤1 y) graft survival were compared between groups to evaluate the impact of D/R BSA on kidney transplantations from pediatric donors.

RESULTS: All demographics and early postoperative complications of group A were similar to those of group B (P > .05). eGFR in group A and group B at 1, 3, 6, and 12 months after transplantation were: 63.2 ± 5.0 vs 74.0 ± 7.6 (P = .008), 66.2 ± 4.9 vs 75.8 ± 5.9 (P = .004), 69.0 ± 4.8 vs 79.0 ± 6.3 (P = .004), and 69.4 ± 7.9 vs 79.2 ± 8.4 (P = .033). Short-term graft survival of group A was inferior to that of group B (62.5% vs 94.4%; P = .042).

CONCLUSIONS: We conclude that recipients with high D/R BSA are more likely to have better graft function. It is possible to make optimal allocation of pediatric donor kidneys on the basis of D/R BSA ≥0.8.