Kidney transplantation outcomes for adult recipients of pediatric donor kidneys

AbstractDespite a paucity of data assessing transplantation of deceased‐donor pediatric donor kidneys into adult recipients, utilization of pediatric organs is declining in the UK, likely due to concerns that such organs may have inferior outcomes. However, we hypothesized that these concerns may be unfounded. As such, the aim of the study was to compare kidney transplant outcomes between adult recipients of pediatric and adult deceased‐donor organs. Data were collected from the UK Transplant Registry for all adult (18+ years) deceased‐donor single‐kidney transplant recipients between January 2000 and January 2016. Univariable and multivariable analyses were undertaken, to compare a range of outcomes between recipients of kidneys from pediatric and adult donors. Transplants were stratified by the donor age (years) as follows: 0‐16 (n = 666), 17‐18 (n = 465), and 19‐44 (n = 7378). Recipients of pediatric donor kidneys were observed to have improved long‐term graft function, with a median creatinine at 1 year of 109 vs. 117 μmol/L for recipients of donors aged 0‐16 vs. 19‐44 years (P < .001). However, on multivariable analysis, this was not found to correspond to a significant difference in patient (P = .914) or graft survival (P = .190) between the donor age groups. Subgroup analysis within the younger donors found no significant differences in recipient outcomes between donors aged 0‐6, 7‐12, and 13‐16 years. In this population cohort study, we identified excellent outcomes among adult recipients of pediatric donor kidneys. Pediatric donors are a valuable source of organs for adult recipients in an era where organ demand is rising.