LONG TERM FOLLOW UP FROM EN BLOC PEDIATRIC KIDNEY TRANSPLANTS:

612 The aim of the present retrospective study was to compare the long-term outcome and function of renal transplants from en bloc pediatric with transplants from single transplant from cadaveric adult donors. METHODS: In our center since 1992 we performed en bloc pediatric transplant. From this date until September 1998, 398 renal transplant was realized, 280 from adult cadaveric heart beating donors (AD) and 42 en bloc pediatric transplant (PD) (age donor 20.7 ± 1.5 months). The following variables were retrospectively reviewed: demographic characteristics of the patients, weight, HLA compatibility, time of post-transplant acute tubular necrosis (ATN), time of post-transplant hospitalization, number and type of rejection, serum creatinine, creatinine clearance and proteinuria (during 5 years). Graft and patient survival rates were also evaluated. Kaplan-Meier time-to-event curves for graft and patient survival were performed RESULTS: Renal function was better in PD at any time (p=0.000) and it is summarized in the following table. There was not significant difference between the incidence of rejection. The duration of post-transplant ATN was 0.51 ± 0.37 days in PD and 3.01 ± 0.43 days in AD (p=0.000). Graft survival at 1 and 5 year was 88.2% and 80.8 in AD vs 80.8 in PD (p=0.392). Graft lose in PD came in the first three months. The main causes of graft lost were surgery complications (arterial and/or venous thrombosis) in PD (87.5%) and acute rejection in AD (39%). Ten grafts were lost in AD because of chronic rejection and any in PD. Patient survival was similar (87% in AD vs 85% in PD at 5 years).TableCONCLUSIONS: If surgical problems are overcome, en bloc pediatric kidneys are the better type of transplants, since the recipient receive double nephronal mass than single adult transplant and as consequence the renal function is superior. It is remarkable the absence of chronic nephropathy at this kind of transplant in our study.