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Giuliani, S; Gamba, PG; Chokshi, NK; Gasparella, P; Murer, L; Zanon, GF.
The effect of donor/recipient body surface area ratio on outcomes in pediatric kidney transplantation.
Pediatr Transplant. 2009; 13(3): 290-299. Doi: 10.1111/j.1399-3046.2008.01034.x
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Co-authors Med Uni Graz
Gasparella Paolo
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Abstract:
In pediatric kidney transplantation, the effect of inadequate nephron dosing on graft survival remains undetermined. The aim of this study was to assess the use of D/R BSA, as a reliable indicator of adequate nephron dosing, and eventually a tool to optimize pediatric graft allocation. Following Institutional Review Board approval, we reviewed deceased donor pediatric kidney transplantation (N = 156). We divided patients into three groups, based on D/R BSA: A < or =0.8; B 0.81-1.19; C > or =1.2. Five-yr graft survival rates in the groups were: A 82.0%; B 94.9%; C 97.1% (p = 0.01). Group C had the lowest rate of acute rejection, suggesting a protective effect of increased D/R BSA (group A = 35.7%, group B = 38.9%, group C = 18.8%; p = 0.029). The logistic regression analysis showed that decreased D/R BSA ratio is a risk factor for loss of graft function, at one and five yr [i.e., group A OR 6 (95% CI 1.14-39.30, p = 0.015) and OR 4.49 (95% CI 1.46-13.79, p = 0.009), respectively]. We conclude that for pediatric recipients, D/R BSA is a valuable adjunct when determining long-term graft survival. Its utility may avoid an alloimmune-independent risk factor, increasing the long-term protective value of a good matching policy.
Find related publications in this database (using NLM MeSH Indexing)
Adolescent -
Body Surface Area -
Child -
Female -
Graft Survival - physiology
Humans -
Kidney - anatomy & histology
Kidney Failure, Chronic - surgery
Kidney Transplantation -
Male -
Organ Size -
Tissue Donors -
Treatment Outcome -

Find related publications in this database (Keywords)
pediatric
kidney transplant
size mismatch
outcome
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