Kidney transplantation from small pediatric donors: does recipient body mass index matter?
Summary of "Kidney transplantation from small pediatric donors: does recipient body mass index matter?"
BACKGROUND.: The influence of recipient body mass index (BMI) on pediatric-donor kidney transplant outcomes is unclear. We aimed to determine graft survival and functional outcomes of pediatric-donor kidneys compared with adult kidneys stratified by recipient BMI group. METHODS.: Scientific Registry of Transplant Recipients data for recipients from 1996 to 2010 were reviewed. Donors were categorized by transplant type, pediatric single kidney transplant (SKT, n=3712), en bloc kidney transplant (EBK, n=1517), or adult standard criteria donor (SCD, n=66,741). Recipients were stratified by BMI tertiles (<24, 24-29, and >29 kg/m). RESULTS.: SKT and EBK from donors ≤40 kg conferred similar risks of adjusted death-censored graft survival relative to SCDs regardless of recipient BMI except for EBK transplants in recipients with BMI <24 where the effect was protective (adjusted hazard ratio [aHR] 0.71, 95% confidence interval [CI] 0.56-0.94). SKT from donors ≤20 kg conferred worse death-censored graft survival in recipients with BMI <24 (aHR 1.3, 95% CI 1.0-1.6) and BMI >29 (aHR 1.5, 95% CI 1.1-2.0); however, most of the risk appeared early, and the effect was abrogated with reanalysis conditional on 1-year graft survival. Compared with SCDs, 1-year glomerular filtration rates of SKT from donors ≤20 kg were significantly higher when transplanted into recipients with BMI <24 (P<0.01) and similar in the other BMI groups. CONCLUSION.: Increasing recipient BMI is not a clear risk factor for outcomes or graft function after transplantation with small pediatric-donor kidneys.
Affiliation
1Department of Surgery, Montefiore Medical Center, Bronx, NY. 2Department of Surgery, University of Florida, Gainesville, FL. 3Department of Medicine, University of Florida, Gainesville, FL.
Journal Details
This article was published in the following journal.
Name: Transplantation
ISSN: 1534-6080
Pages: 430-6
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22262130
- DOI: http://dx.doi.org/10.1097/TP.0b013e318241d57d
Medical and Biotech [MESH] Definitions
Transplantation Conditioning
Preparative treatment of transplant recipient with various conditioning regimens including radiation, immune sera, chemotherapy, and/or immunosuppressive agents, prior to transplantation. Transplantation conditioning is very common before bone marrow transplantation.
Transplantation, Heterotopic
Transplantation of tissue typical of one area to a different recipient site. The tissue may be autologous, heterologous, or homologous.
Kidney Failure, Chronic
The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION.
Kidney Transplantation
The transference of a kidney from one human or animal to another.
Tissue And Organ Procurement
The administrative procedures involved with acquiring TISSUES or organs for TRANSPLANTATION through various programs, systems, or organizations. These procedures include obtaining consent from TISSUE DONORS and arranging for transportation of donated tissues and organs, after TISSUE HARVESTING, to HOSPITALS for processing and transplantation.
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