The high demand for organs for transplantation has made it necessary to con
sider using even the oldest and youngest of potential donors in order to in
crease the organ supply. In this retrospective study, the outcome of kidney
transplantation using cadaveric pediatric donors was compared with that of
an adult control series. Graft procurement took place in two regions of It
aly (Emilia-Romagna and Piemonte) over an Ii-year period. A group of pediat
ric donors (< 15 years old, n = 30) was compared with an adult donor group
(n = 67). All recipients were adults who received cyclosporin as immunosupp
ression. Actuarial patient and graft survival rates did not differ signific
antly between the two groups (patient survival 96 % and 96 % for pediatric
donors versus 98 % and 92 % for adult donors at 1 and 5 years post-transpla
ntation; graft survival 76 % and 68 % for pediatric donors versus 88 % and
74 % for adult donors 1 and 5 y post-transplantation). Complications were a
lso evaluated, but no difference was found (the only exception being the cr
eatinine level in the 5th year). Renal transplantation with cadaveric donor
s starting at 4 years of age gave results comparable to kidneys coming from
adults. These data show that cadaveric pediatric donor kidneys may be used
in adult recipients with good results. The ethical implications of the sub
ject are extensively reviewed.