Comparison of Outcomes of Kidney Transplantation From Extremely Low Body Weight ≤5kg Versus Larger Body Weight Pediatric Donors

作者：Jiawei Peng, Helong Dai, Hedong Zhang, Shaojie Yu, Xubiao Xie, Fenghua Peng, Gongbin Lan, Shanbiao Hu, Yu Wang, Xiaotian Tang, Yong Guo, Chen Gao, Chunhua Fang, Manhua Nie, Xiao-Qiong Yuan, Mingda Zhong, Zhouqi Tang, Tengfang Li, Siyu Sun, Hengchang Yao, Jianfei Hou, Ruixue Huang, Longkai Peng · 发表于：Frontiers in Immunology · 年份：2021 · DOI：10.3389/fimmu.2021.738749 · 被引用次数：7 · 研究领域：Renal Transplantation Outcomes and Treatments、Organ Donation and Transplantation、Organ Transplantation Techniques and Outcomes

Background: Kidney transplantation from donors who weigh ≤5 kg is performed at only a few transplant centers owing to the high complication and low graft survival rates associated with this approach. Methods: We retrospectively compared the results of kidney transplantation at our center between January 2015 and December 2019 based on the following pediatric donor criteria: donor body weight ≤5 kg (n=32), 5 kg< donor weight ≤20 kg (n=143), and donor weight >20 kg (n=110). We also perform subgroup analysis of kidney transplantation outcomes from ≤5 kg donors, using conventional (dual separate and classic en-bloc KTx)/novel (en-bloc KTx with outflow tract) surgical methods and allocating to adult/pediatric recipients. Results: The death-censored graft survival rates from extremely low body weight ≤5kg at 1 month, and 1, 3, and 5 years were 90.6%, 80.9%, 77.5%, and 73.9%, respectively, which were significantly lower than that from larger body weight pediatric donors. However, the 3-, and 5-year post-transplantation eGFRs were not significantly different between the pediatric and adult recipient group. The thrombosis (18.8%) and urinary leakage (18.8%) rates were significantly higher in the donor weight ≤5 kg group. Compared with 5 kg< donor weight ≤20 kg group, donor weight ≤5kg group was at elevated risk of graft loss due to thrombosis (OR: 13.4) and acute rejection (OR: 6.7). No significant difference on the outcomes of extremely low body weight donor kidney transplantation wa...