Transplantation of cadaveric paediatric donor kidneys into adult recipients.

To assess the justification for the use of cadaveric paediatric donor (CPD) kidneys in adult recipients, the results of transplantation of 50 CPD kidneys into adult recipients (CPD group) were compared to the outcome of 250 transplantations of adult cadaveric donor kidneys into adult recipients (ACD group). No differences in graft and patient survival were observed between both groups. The functional capacity of the kidneys and the incidence of surgical and urological complications was not different in both groups. Hypertension was observed more frequently in recipients of CPD kidneys compared to recipients of ACD kidneys (p less than 0.025). The occurrence of hypertension was related to the surgical technique used for the arterial anastomosis. When no arterial patches were available hypertension occurred more frequently in the CPD group (9/9 cases) compared to the ACD group (31/70 cases) (p less than 0.01). In recipients of CPD kidneys the incidence of hypertension was lower then arterial patches were used (11/19 cases) compared to recipients of CPD kidneys where no patches were used (9/9) (p less than 0.05). The results indicate that the use of CPD kidneys in adult recipients is justified. However, to diminish the occurrence of hypertension, donor nephrectomy of CPD kidneys should take place according to the so-called en bloc technique, so that arterial patches can be obtained.