A comparison of pedriatric and adult kidney donors for adult recipients

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.