RADIOISOTOPIC EVALUATION OF RENAL-FUNCTION IN CYCLOSPORINE-TREATED PEDIATRIC AND ADULT RENAL-TRANSPLANT RECIPIENTS AND THEIR LIVING DONORS - A STUDY OF 152 DONOR-RECIPIENT PAIRS

Renal function was studied in 2 groups of renal transplant recipients and their donors by technetium-99m diethylenetriamine pentaacetic acid and a gamma camera. The pediatric group (group A) comprised 40 childr en and their adult kidney donors. The adult group (group B) consisted of 112 consecutive adult renal transplant recipients and their adult d onors. All patients received kidneys from living donors and were given the same immunosuppression protocol (PRED plus CSA). Donor glomerular filtration rate (GFR) was determined before nephrectomy and at a mean period of 30 (range 10-50) months after nephrectomy. The graft GFR wa s measured at 1, 3, 6, and 12 months and at the most recent follow-up visit. Moreover, the functional reserve of the graft was assessed by i nfusion of dopamine and an amino acid. The post/nephrectomy GFR of don ors in groups A and B were 74+/-18 and 72+/-20 ml/min/1.73 m(2), respe ctively. The GFR of pediatric recipients was significantly lower than that of adult recipients at corresponding time points along the course of follow-up. The mean values of graft GFR were 47.6+/-20 and 63.8+/- 29.6 ml/min/1.73 m(2) for pediatric and adult recipients, respectively (P<0.001). Moreover, the graft functional reserve was significantly l ower in pediatric recipients. These data demonstrate that adult kidney s transplanted into pediatric recipients have lower GFR than those tra nsplanted into adults, despite corrections for body surface area. Alth ough the reason for this phenomenon is unknown, the observation may ha ve important implications for management of pediatric recipients.