Skip to main content

Advertisement

Log in

Kidney Transplantation from Pediatric Donors in a Single Chinese Center

  • Original Paper
  • Published:
Cell Biochemistry and Biophysics Aims and scope Submit manuscript

Abstract

To report clinical outcomes of kidney transplantation from pediatric brain and cardiac death donors (DBCD) in a single Chinese center and to investigate its feasibility to expand organ donor pool. 18 recipients, transplanted between August 2011 and October 2013 in the First Affiliated Hospital of Zhengzhou University, receive a single graft from DBCD donors age ranged from 1.5 to 13 years old. Renal function expressed as serum creatinine, blood urea nitrogen as well as eGFR values at 1, 2 weeks as well as 1-, 3-, 6-, and 12-months post-transplantation was evaluated. Graft size was also monitored at the same time by ultrasonography. In addition, delayed graft function, acute rejection, surgical complication as well as patient and graft survival were also assessed. The primary causes of DBCD donors included six cases of severe brain trauma and three cases of cerebral hemorrhage. The mean age of DBCD donors was (7.2 ± 3.4) years (range 1.5–13). The mean weight of DBCD donors was (29.8 ± 15.3) kilogram (range 13–67). The mean height of DBCD donors was (118.3 ± 27.8) centimeter (range 70–173). ECMO was applied to DBCD donors to avoid warm ischemia time and the applicating time was (79.8 ± 44.5) (range 32–180) minutes.There were seven males and 11 females recipients. Among which, 16 recipients were pediatrics and two recipients were adults. The mean age of the recipients was (14.6 ± 9.7) years (range 4–47). The mean weight of recipients was (31.9 ± 12.4) kilogram (range 11–54). The mean height of recipients was (138.0 ± 23.7) centimeter (range 84–172). Renal function recovered to normal within the first-week post-operation except one recipient which occurred acute rejection. Two cases of renal artery stenosis were found 2-week and 3-month post-transplantation, respectively. They subsequently underwent ballon angioplasty and followed up for 8 and 12 months, respectively, and no recurrence was found. One recipient developed ureteral leak. Five weeks later, the ureter leak healed after adequate drainage and prolongation of indwelling catheter. Graft size significantly and continuously increased during the first year, especially in the first 3-month post-transplantation. All the 18 recipients are alive at the last follow-up. Among which, 16 recipients are followed up for 12 months and 1-year recipient/graft survival rate is 100 %. The use of single kidney graft from pediatric DBCD could yield good short-term results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Huang, J. F. (2013). Constructing a national system for organ donation and transplantation. Zhonghua Wai Ke Za Zhi, 51, 1–3.

    PubMed  Google Scholar 

  2. Chen, G. D., Shiu-Chung Ko, D., Wang, C. X., Qiu, J., Han, M., He, X. S., et al. (2013). Kidney transplantation from donors after cardiac death: an initial report of 71 cases from China. American Journal of Transplantation, 13(5), 1323–1326.

    Article  PubMed  Google Scholar 

  3. http://www.baidu.com/link?url=4f7wckWrL4AljAhbmwEJDiuh8ZuFoxzqZJjGnt6Aq8vFit9Hmst20hr8kZwSQPvgaVeS4gjqiyVWkvMzNA5rb18icKWa5pYbv-x9YBrhmy1tTqPY9Znr0MpJvsjttJFP.

  4. Huang, J., Millis, J. M., Mao, Y., Millis, M. A., Sang, X., & Zhong, S. (2012). A pilot programme of organ donation after cardiac death in China. Lancet, 379(9818), 862–865.

    Article  PubMed  Google Scholar 

  5. Huang, J. F. (2013). Pragmatic solution for organ donation in response to challenges faced by the Chinese society: Summary for the National Donation after Circulatory Death Pilot Program. Chinese Medical Journal, 126(3), 569–573.

    PubMed  Google Scholar 

  6. Casavilla, A., Ramirez, C., Shapiro, R., Nghiem, D., Miracle, K., Fung, J. J., et al. (1995). Experience with liver and kidney allografts from non-heart-beating donors. Transplantation Proceedings, 59, 197–203.

    Article  CAS  Google Scholar 

  7. Ma, Y., Wang, G. D., He, X. S., Li, Q., Li, J. L., Zhu, X. F., et al. (2010). Simultaneous liver and kidney transplantation: Analysis of a single-center experience. Chinese Medical Journal, 123, 1259–1263.

    PubMed  Google Scholar 

  8. Shang, W., Feng, G., Gao, S., Wang, Z., Pang, X., Li, J., et al. (2014). Reduced ATG-F dosage for induction in pediatric renal transplantation: A single-center experience. Pediatric Transplantation, 18(3), 240–245.

    Article  CAS  PubMed  Google Scholar 

  9. Feng, G. W., Guo, T., Li, J. F., Shang, W. J., Lei, J., Wang, Z. G., et al. (2013). CYP3A5 gene polymorphism and individualized administration of tacrolimus after kidney transplantation. Chinese Journal of Organ Transplantation, 34, 647–650.

    CAS  Google Scholar 

  10. Solez, K., Colvin, R. B., Racusen, L. C., Haas, M., Sis, B., Mengel, M., et al. (2008). Banff 07 classification of renal allograft pathology: updates and future directions. American Journal of Transplantation, 8, 753–760.

    Article  CAS  PubMed  Google Scholar 

  11. Standard for Brain Death Decision Drafting Group, Ministry of Health. (2003). Technical specifications for brain death (adult) draft. Chinese Medical Journal, 83, 262–264.

    Google Scholar 

  12. Chen, Z., Zeng, F., Ming, C., Ma, J., & Jiang, J. (2006). Current situation of organ donation in China-from stigma to stigmata. American Journal of Transplantation, 6(suppl), 437.

    Google Scholar 

  13. Huang, J. (2007). Ethical and legislative perspectives on liver transplantation in the People’s Republic of China. Liver Transplantation, 13, 193–196.

    Article  PubMed  Google Scholar 

  14. Jianmin, Q., & Zhenyu, M. (2009). History of cardiac death organ donation and transplantation. Chinese Journal of Transplantation, 3, 273–276.

    Google Scholar 

  15. Yongfeng, L. (2009). Ethics of donors of cardiac death and its application in liver transplantation. Chinese Journal of Transplantation, 3, 4.

    Google Scholar 

  16. Huang, J., Wang, H., Fan, S. T., Zhao, B., Zhang, Z., Hao, L., et al. (2013). The National Program for deceased organ donation in China. Transplantation, 96, 5–9.

    Article  PubMed  Google Scholar 

  17. Zhong-hua, C. (2010). New sight after a quarter century: A long Chinese way to tackle the organ shortage in the era of worldwide organ crises. Chinese Journal of Transplantation, 4, 265–272.

    Google Scholar 

  18. Keizer, K. M., de Fijter, J. W., Haase-Kromwijk, B. J., & Weimar, W. (2005). Non-heartbeating donor kidneys in the Netherlands: Allocation and outcome of transplantation. Transplantation, 79, 1195–1199.

    Article  PubMed  Google Scholar 

  19. Reich, D. J., Mulligan, D. C., Abt, P. L., Pruett, T. L., Abecassis, M. M., D’Alessandro, A., et al. (2009). ASTS Standards on Organ Transplantation Committee. ASTS recommended practice guidelines for controlled donation after cardiac death organ procurement and transplantation. American Journal of Transplantation, 9, 2004–2011.

    Article  CAS  PubMed  Google Scholar 

  20. Zampieri, F. G., Mendes, P. V., Ranzani, O. T., Taniguchi, L. U., Pontes Azevedo, L. C., Vieira Costa, E. L., et al. (2013). Extracorporeal membrane oxygenation for severe respiratory failure in adult patients: A systematic review and meta-analysis of current evidence. Journal of Critical Care, 28, 998–1005.

    Article  PubMed  Google Scholar 

  21. Mendiratta, P., Wei, J. Y., Gomez, A., Podrazik, P., Riggs, A. T., Rycus, P., et al. (2013). Cardiopulmonary resuscitation requiring extracorporeal membrane oxygenation in the elderly: A review of the Extracorporeal Life Support Organization registry. ASAIO Journal, 59, 211–215.

    Article  PubMed  Google Scholar 

  22. Gravel, M. T., Arenas, J. D., Chenault, R, 2nd, Magee, J. C., Rudich, S., Maraschio, M., et al. (2004). Kidney transplantation from organ donors following cardiopulmonary death using extracorporeal membrane oxygenation support. Annals of Transplantation, 9, 57–58.

    PubMed  Google Scholar 

  23. Magliocca, J. F., Magee, J. C., Rowe, S. A., Gravel, M. T., Chenault, R. H, 2nd, Merion, R. M., et al. (2005). Extracorporeal support for organ donation after cardiac death effectively expands the donor pool. Journal of Trauma, 58, 1095–1101.

    Article  PubMed  Google Scholar 

  24. McCunn, M., & Reed, A. J. (2009). Critical care organ support: a focus on extracorporeal systems. Current Opinion in Critical Care, 15, 554–559.

    Article  PubMed  Google Scholar 

  25. Rudich, S. M., Arenas, J. D., Magee, J. C., Gravel, M. T., Chenault, R. H, 2nd, Kayler, L. K., et al. (2002). Extracorporeal support of the nonheart-beating organ donor. Transplantation, 73, 158–159.

    Article  PubMed  Google Scholar 

  26. Ko, W. J., Chen, Y. S., Tsai, P. R., & Lee, P. H. (2000). Extracorporeal membrane oxygenation support of donor abdominal organs in non-heart-beating donors. Clinical Transplants, 14, 152–156.

    Article  CAS  Google Scholar 

  27. Kayler, L. K., Magliocca, J., Kim, R. D., Howard, R., & Schold, J. D. (2009). Single kidney transplantation from young pediatric donors in the United States. American Journal of Transplantation, 9, 2745–2751.

    Article  CAS  PubMed  Google Scholar 

  28. Kayler, L. K., Magliocca, J., Fujita, S., Kim, R. D., Zendejas, I., Hemming, A. W., et al. (2009). Recovery factors affecting utilization of small pediatric donor kidneys. American Journal of Transplantation, 9, 210–216.

    Article  CAS  PubMed  Google Scholar 

  29. Satterthwaite, R., Aswad, S., Sunga, V., Shidban, H., Mendez, R. G., Bogaard, T., et al. (1997). Outcome of en bloc and single kidney transplantation from very young cadaveric donors. Tranplantation, 63, 1405–1410.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

This study was supported by Chinese Natural Science Foundation (U1204820) and Henan Province Natural Science Foundation Research Project(122300410190).

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Gui-wen Feng or Wen-jun Shang.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, Jf., Liu, J., Guo, T. et al. Kidney Transplantation from Pediatric Donors in a Single Chinese Center. Cell Biochem Biophys 70, 1713–1717 (2014). https://doi.org/10.1007/s12013-014-0118-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12013-014-0118-y

Keywords

Navigation