Study of the effect of donor source on graft and patient survival in pediatric renal transplant recipients
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ORIGINAL ARTICLE
Study of the effect of donor source on graft and patient survival in pediatric renal transplant recipients Osama Gheith & Alaa Sabry & Sherief Abd El-Baset & Nabil Hassan & Hussein Sheashaa & Sameh Bahgat & El-Metwally El-Shahawy
Received: 25 May 2007 / Revised: 8 December 2007 / Accepted: 13 December 2007 / Published online: 30 April 2008 # IPNA 2008
Abstract Evaluation of the impact of live unrelated kidney donor (LURD) source on the outcome of renal transplantation is not adequately studied. We aimed to compare the long-term outcome of kidney transplantation from LURDs to that from living related donors (LRDs) among a pediatric recipient population. This study comprised 235 pediatric recipients who received their kidney grafts between 1976 and 2005 at our center. These patients were further subdivided into two groups according to donor source (211 with LRDs) and (24 with LURDs). All patients’ data were assessed with special emphasis on graft and patient survival as well as posttransplant medical complications. Both groups were comparable regarding graft and patient survival at 1, 5, and 10 years. Despite higher incidence of acute vascular rejection among recipients with LURD (12%) vs. LRD (2.8%) (P=0.03), there was no difference in the incidence of chronic allograft nephropathy. Moreover, the overall incidence of posttransplant complications was comparable among the two groups. In our series, kidney survival was poorer in LURDs compared with LRDs. However, the number of patients with LURD was small, and the difference in results was also small and justifies LURD in exceptional cases when LRD is not possible. Keywords Kidney transplantation . Live donor . Unrelated . Pediatrics O. Gheith (*) : A. Sabry : S. A. El-Baset : N. Hassan : H. Sheashaa Nephrology Unit, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt e-mail: [email protected] S. Bahgat : E.-M. El-Shahawy Department of Internal Medicine, Benha University, Benha, Egypt
Introduction The widening gap between the demand for and supply of donor kidneys has led to a call for an expansion in the potential donor pool and kidney donation by biologically unrelated persons that have been attempted in different areas of the world, including the Middle and Far East [1]. These donations have received adverse publicity because of a combination of factors, including unresolved ethical issues such donor payment and possible coercion, unacceptably high donor and recipient morbidity and mortality, and poor allograft survival rates [2–4]. In the US in particular, but also in other countries, kidney transplantation from a live unrelated donor (LURD) was described as early as the mid-1980s with good short- [5, 6] and longterm results [7]. Results of living unrelated donation (LRD) resulted in some controversies, whereas excellent patient and graft survivals were observed in some studies, with 1year graft survival being 94.2% in the LRD group and 100% in the LURD group, 85% at 1 year in Norway, and 85% after 3 years in the USA [8]. Evaluati
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