A Case-control Study Of Clinical Efficacy And Survival Analysis Of Kidney Transplantation From Adult Donor With Pediatric Donors

Objective: In this study,the clinical effect of kidney transplantation from pediatric donors was compared with that of kidney transplantation from adult donors through a matched method,and the survival effects of kidneys from different age groups on transplant recipients were compared without matching,so as to jointly explore the feasibility and clinical value of kidney transplantation from pediatric donors.Methods: We retrospectively analyzed the clinical history of all kidney transplantations from DBCD-donors,which performed in the Second affiliated hospital of university of south China between January 2015 and January 2019.74 kidney transplant recipients,whose graft comes from pediatric donors,were included in the test group.195 kidney transplant recipients,whose graft comes from adult donors,were included in the control group.We matched the two groups 1: 1 according to certain matching conditions,and the two groups were successfully included in 50 recipients finally.We then compared the recovery of renal function,the size of the transplanted kidney,the incidence of various adverse events within 1 year after surgery,and compared the 5-year renal survival rate of all transplant recipients before matching.Results: One years later,the average SCR(serum creatinine)and the percentage decrease of SCR in the test group were(107.13±58.22)and 89.10%,and the data for the control group were(108.22±12.78).There was no significantly difference in renal function recovery between the two groups(P>0.05).The length of the kidney in the test group increased from(90.28±14.97)mm to(116.06±9.20)mm,which was close to the size of normal adult kidneys.The length of the kidney in the control group increased from(108.72±5.73)mm to(124.58±6.80)mm.The incidence of proteinuria in the test group after one year was 38.58%,the data for the control group was 14.00%.There was a significantly higher incidence of proteinuria in the test group compared with the control group(P<0.05).There were no significantly difference in other adverse events between the two groups.Patients and graft survival rates in the test group after 5 years were similar to that in the control group.Conclusions: Compared with adult-donor kidney transplantation,although the incidence of proteinuria is higher in pediatric-donor kidney transplantation at 1 year after,the renal function recovery and adverse events are similar at 1 year after,and the growth rate of pediatric kidney is faster and the growth rate is larger 1 year later,which means there is no significant difference in the early-term clinical efficacy between the two group.There is no significant difference in the patients and graft survival between the two groups within 5 years,which indicate that the pediatric-donor kidney transplantation had the same medium-term clinical efficacy as adult-donor kidney transplantation.