Immunosuppressive therapy in kidney transplantation using pediatric DCD donors

Objective To investigate an appropriate immunosuppressive therapy in kidney transplantation using pediatric donation after citizen death (DCD) donors. Method From July 2013 to Aug. 2015, a total of 46 renal transplants were performed in our center using kidneys from pediatric DCD donors. Forteen were given en bloc kidney transplantation and the rest 32 cases were subjected to single kidney transplantation. The average donor age and recipient body weight was 61.2±63.2 days and 39±9.9 kg in en bloc renal transplantation, and 2.8±2.3 days and 47.3±10.6 kg in single renal transplantation, respectively. Most patients with en bloc renal transplantation received an induction therapy of rATG, followed by a maintenance immunosuppression of CsA/MPA/Prednisone. For patients with single renal transplantation, either rATG or anti-CD25 was given as induction therapy, then mostly followed by tacrolimus combined with MMF or MPA and prednisone as maintenance immunosuppression. Result In en bloc kidney transplantation group, only 2 panties had DGF (14.3%), 1 patient had pneumonia (7.1%), and no one developed acute rejection. In single kidney transplantation group, DGF happened in 4 patients (12.5%), acute rejection was developed in 2 patients and pneumonia occurred in 6 patients (18.8%). Conclusion By choosing appropriate immunosuppressive regimen according to the specificity of renal transplantation with pediatric kidneys, excellent early outcome can be achieved. Key words: Kidney transplantation; Transplants; Child; Donors; Immunosuppressive Agents