International Urology and Nephrology

, Volume 13, Issue 1, pp 95–104 | Cite as

The use of pediatric cadaver kidneys in renal transplantation (Experience with 97 cases and comparison with adult kidneys)

  • L. G. Managadze
  • H. Oesterwitz
  • D. Scholz
  • G. May
  • M. Mebel


Pediatric cadaver donors are an important pool of kidneys for human allotransplantation. Experiences with 97 transplantations of pediatric cadaveric kidneys (age: 4 months to 15 years) and comparison with 230 transplantations of adult kidneys (age: 16–25 and 40–68 years) are presented. The cumulative patient survival was similar in both groups, however, the graft survival was significantly lower in the pediatric donor group (p<0.05). This difference was established almost exclusively within the first 3 months after transplantation. In this group the percentage of technical complications in the first month was higher (13.4%) than in the adult kidney group (6.5%). The analysis of the whole pool of harvested kidneys shows a significantly higher rate of transplanted kidneys in the pediatric group (61%) as compared with the adult group (44.7%). In both groups the mode of arterial vascular anastomosis (end-to-end or end-to-side) does not influence the graft survival.

Further investigations on pediatric donor kidneys are necessary. The utilization of pediatric cadaveric kidneys for transplantation should be increased because 20–25% of all potential kidney donors are younger than 15 years.


Public Health Patient Survival Renal Transplantation Graft Survival Donor Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Advisory Committee ACS/NIH Renal Transplant Registry: The 13th report of the human renal transplant registry.Transplant. Proc., 9, 9 (1977).Google Scholar
  2. 2.
    Andersen, O. S., Jonasson, O., Merkel, F. K.: En bloc transplantation of pediatric kidneys into adult patients.Arch. Surg., 108, 35 (1974).PubMedGoogle Scholar
  3. 3.
    Bart, K. J.: The prevalence of cadaveric kidneys for transplantation. Amer. Ass. Tissue Banks, Proc. 1977, p. 124.Google Scholar
  4. 4.
    Bart, K. J., Macon, E. J., Humphries, A. L.: A response to the shortage of cadaveric kidneys for transplantation.Transplant. Proc., 11, 455 (1979).PubMedGoogle Scholar
  5. 5.
    Belzer, F. O., Schweitzer, R. T., Holliday, M., Potter, D., Kountz, S. L.: Renal homotransplantation in children.Am. J. Surg., 124, 270 (1972).PubMedGoogle Scholar
  6. 6.
    Belzer, F. O., Schweitzer, R. T., Kountz, S. L.: Management of multiple vessels in renal transplantation.Transplant. Proc., 4, 639 (1972).PubMedGoogle Scholar
  7. 7.
    Boczko, S., Tellis, V., Veith, F. J.: Transplantation of children's kidneys into adult recipients.Surg. Gynec. Obstet. 146, 387 (1978).PubMedGoogle Scholar
  8. 8.
    Braun, E.: Eine einfache Methode der Ureteroneozystostomie mit extravesikaler submuköser Tunnelbildung.Zschr. Urol., 66, 765 (1973).Google Scholar
  9. 9.
    Chailley, J., Lanson, J., Gagnadouy, M.-F., Lenoir, G., Guespy, P., Beurton, D., Broyer, M., Cukier, J.: Les transplantation rénales de l'enfant.J. Urol. Néphrol. 76, 173 (1978).Google Scholar
  10. 10.
    Chlepas, S., Sigel, A.: Einfache oder doppelte en-bloc-Transplantation von Kindernieren auf Erwachsene?Acta Urol., 10, 65 (1979).Google Scholar
  11. 11.
    Darmady, E. M.: Transplantation and the ageing kidney.Lancet, II, 1046 (1974).Google Scholar
  12. 12.
    Dreikorn, K., Röhl, L., Horsch, R.: The use of double renal transplants from pediatric cadaver donors.Brit. J. Urol., 49, 361 (1977).PubMedGoogle Scholar
  13. 13.
    EDTA Registration Committee: Combined report, including paediatrics, on regular dialysis and transplantation in Europe, IV, 1973.Proc. EDTA, 11, 2 (1974).Google Scholar
  14. 14.
    EDTA Registration Committee: Combined report on regular dialysis and transplantation in Europe, IX, 1978.Proc. EDTA, 16, 3 (1979).Google Scholar
  15. 15.
    Fine, R. N., Brennan, L. P., Edelbrock, H. H., Riddell, H., Stiles, Q., Lieberman, E.: Use of pediatric cadaver kidneys for homotransplantation in children.JAMA, 210, 477 (1969).PubMedGoogle Scholar
  16. 16.
    Fine, R. N., Korsch, B. M., Stiles, Q., Riddell, H., Edelbrock, H. H., Brennan, L. P., Grushkin, C. M., Lieberman, E.: Renal homotransplantation in children.J. Pediat., 76, 347 (1970).PubMedGoogle Scholar
  17. 17.
    Fine, R. N., Korsch, B. M., Brennan, L.-P., Edelbrock, H. H., Stiles, Q., Riddell, H., Weitzman, J. J., Mickelson, J. C., Tucker, B. L., Grushkin, C. M.: Renal transplantation in young children.Am. J. Surg., 125, 559 (1973).PubMedGoogle Scholar
  18. 18.
    Fox, P. S., Failla, J. P., Kauffman, H. M., Darin, J. C.: The cadaver donor: logistics of supply and demand in an urban population.JAMA, 222, 162 (1972).PubMedGoogle Scholar
  19. 19.
    Glass, N. R., Stillman, R. M., Butt, K. M. H., Kountz, S. L.: Results of renal transplantation using pediatric cadaver donors.Surgery, 85, 504 (1979).PubMedGoogle Scholar
  20. 20.
    Goodwin, W. E., Mims, H. M., Kaufman, J. J.: Human renal transplantation. III. Technical problems encountered in six cases of kidney homotransplantation.J. Urol., 89, 349 (1963).PubMedGoogle Scholar
  21. 21.
    Henriksson, C., Sigström, L., Gustafsson, A., Gelin, L.-E.: Renal transplantation in children.Scand. J. Urol. Nephrol., 38, 99 (1976).Google Scholar
  22. 22.
    Hume, D. M., Lee, H. M., Williams, G. M., White, H. J., Ferré, J., Wolf, J. S., Prout, G. R., Slapak, M., O'Brien, J., Kilpatrick, S., Kauffman, H. M., Cleveland, R. J.: Comparative results of cadaver and related donor homografts in man, and immunologic implications of the outcome of second and paired transplants.Ann. Surg., 164, 352 (1966).PubMedGoogle Scholar
  23. 23.
    Iitaka, K., Martin, L. W., Cox, J. A., Mc Enery, P. T., West, C. C.: Transplantation of cadaver kidneys from anencephalic donors.J. Pediat., 93, 216 (1978).PubMedGoogle Scholar
  24. 24.
    Kelly, W. D., Lillehei, R. C., Aust, J. B., Varco, R. L., Leonhard, A. S., Griffin, W. J., Markland, C., Herdman, R. C., Vernier, R. L., Michael, A. F., Levitt, J.: Kidney transplantation: Experience at the University of Minnesota Hospitals.Surgery, 62, 704 (1967).PubMedGoogle Scholar
  25. 25.
    King, L., Gerbie, A. G., Idriss, F. S., Swensson, O., Sigel, A., Delgreco, F., Grayhack, J., Gross, M., Gonzales, E., Stolpe, Y.: Human renal transplantation with kidney grafts from the newborn.Invest. Urol., 8, 622 (1971).PubMedGoogle Scholar
  26. 26.
    Kinne, D. W., Spanos, P. K., DeShazo, M. M., Simmons, R. L., Najarian, J. S.: Double renal transplants from pediatric donors to adult recipients.Am. J. Surg., 127, 292 (1974).PubMedGoogle Scholar
  27. 27.
    Krneta, A., Tscholl, R.: Transplantationsresultat 2 Jahre nach der Implantation zweier kindlicher Nieren en bloc mit Aorta und V. cava bei einem Erwachsenen.Helv. chir. Acta, 42, 143 (1975).PubMedGoogle Scholar
  28. 28.
    Küss, R., Camey, M., Poisson, J., Chatelain, C.: Aspects chirurgicaux de l'homotransplantation rénale chez l'homme.Mém. Acad. Chir., 92, 624 (1966).Google Scholar
  29. 29.
    La Plante, M. P., Kaufman, J. J., Goldman, R., Gonick, H. C., Martin, D. C., Goodwin, W. E.: Kidney transplantation in children.Pediatrics, 46, 665 (1970).PubMedGoogle Scholar
  30. 30.
    Lawson, R. K., Campbell, R. A., Hodges, C. V.: Renal transplantation in infants and small children.Transplant. Proc., 3, 358 (1971).PubMedGoogle Scholar
  31. 31.
    Lawson, R. K., Bennett, W. M., Campbell, R. Q., Pirofsky, B., Hodges, C. V.: Hyperacute renal allograft rejection in the human neonate.Invest. Urol., 10, 444 (1973).PubMedGoogle Scholar
  32. 32.
    Martin, L. W., Gonzalez, L. L., West, C. D., Swartz, R. A., Sutorius, D. J.: Homotransplantation of both kidneys from an anencephalic monster to a 17-pound boy with Eagle-Barrett syndrome.Surgery, 66, 603 (1969).PubMedGoogle Scholar
  33. 33.
    Meakins, J. L., Smith, E. J., Alexander, J. W.: En bloc transplantation of both kidneys from pediatric donors into adult patients.Surgery, 71, 72 (1972).PubMedGoogle Scholar
  34. 34.
    Merkel, F. K., Ing, T. S., Ahmadian, Y., Lewy, P., Armbruster, K., Oyama, J., Sulieman, J. S., Belam, A. B., King, L. R.: Transplantation in the young.J. Urol., 111, 679 (1974).PubMedGoogle Scholar
  35. 35.
    Morling, N., Ladefoged, J., Lange, P., Nerström, B., Nielsen, B., Staub Nielsen, L., Sörensen, B. L.: Kidney transplantation and the donor age.Tissue Antigens, 6, 163 (1975).PubMedGoogle Scholar
  36. 36.
    Munda, R., Alexander, J. W., First, M. R., Fidler, J. P.: Hypothermic pulsatile perfusion and transplantation of pediatric cadaveric kidneys into adults.Am. J. Surg., 44, 451 (1978).Google Scholar
  37. 37.
    Najarian, J. S., Simmons, R. L., Tallent, M. B., Kjellstrand, C. M., Buselmeier, T. J., Vernier, R. L., Michael, A. F.: Renal transplantation in infants and children.Ann. Surg., 174, 583 (1971).PubMedGoogle Scholar
  38. 38.
    Opelz, G., Terasaki, P. I.: Cadaver kidney transplant in North America: Analysis 1978.Dial. & Transplantation, 8, 167 (1979).Google Scholar
  39. 39.
    Owens, M. L., Pritchett, T. R., Robertson, T., Simmons, S.: The effect of insulation on warm ischemia during kidney transplantation.J. Surg. Res., 27, 100 (1979).PubMedGoogle Scholar
  40. 40.
    Piza, F.: Zur Verwendung kindlicher Leichen für die homologe Nierentransplantation.Münch. med. Wschr., 112, 2286 (1970).Google Scholar
  41. 41.
    Potter, D., Belzer, F. O., Rames, L., Holliday, M. A., Kountz, S. L., Najarian, J. S.: The treatment of uremia in childhood. I. Transplantation.Pediatrics, 45, 432 (1970).PubMedGoogle Scholar
  42. 42.
    Rice, L. E., Levin, R. B., Jennings, R. B., Iovanovich, P.: Intractable renovascular hypertension in an adult recipient of a pediatric cadaveric renal transplant.Nephron, 17, 279 (1976).PubMedGoogle Scholar
  43. 43.
    Roloff, J. S., Marshall, J. P., Reynolds, J. O., Miller, V. W.: Kidney transplant donors: Estimate of availability by autopsy survey.Arch. Surg., 103, 359 (1971).PubMedGoogle Scholar
  44. 44.
    Salvatierra, O., Belzer, F. O.: Pediatric cadaver kidneys. Their use in renal transplantation.Arch. Surg., 110, 181 (1975).PubMedGoogle Scholar
  45. 45.
    Silber, S. J.: Renal transplantation between adults and children. Differences in renal growth.JAMA, 228, 1143 (1974).PubMedGoogle Scholar
  46. 46.
    Solheim, B. G., Thorby, E., osbakk, T. A., Enger, E.: Donor age and cumulative kidney graft survival.Tissue Antigens, 7, 251 (1976).PubMedGoogle Scholar
  47. 47.
    Wilms, H., Halbfaß, H. J., Daikeler, G.: En-bloc-Transplantation zweier Kindernieren.Zbl. Chir., 104, 249 (1979).Google Scholar
  48. 48.
    Wolf, A., Piza, F., Weissenbacher, G., Pinggera, W. F., Stummvoll, H. K., Wagner, O.: Nierentransplantation bei Kindern.Wien. klin. Wschr., 88, 145 (1976).PubMedGoogle Scholar

Copyright information

© Akadémiai Kiadó 1981

Authors and Affiliations

  • L. G. Managadze
    • 1
  • H. Oesterwitz
    • 1
  • D. Scholz
    • 1
  • G. May
    • 1
  • M. Mebel
    • 1
  1. 1.Kidney Transplantation Center, Berlin-Friedrichshain, Department of Urology, Division of Experimental Organ TransplantationHumboldt-University (Charité)BerlinGDR

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