Organ from a living donor is better when the child needs a new kidney – Consumer Health News

WEDNESDAY, Aug. 17, 2022 (HealthDay News) — Children who need kidney transplants have better long-term outcomes when the donor is a living person and not someone who has died and donated their organs, according to a new study.

“The results of our study should allay the fears and concerns of the centers regarding the acceptance of organs from unrelated living donors,” said the study’s lead author, Dr. Lavjay Butani, Chief of Pediatric Nephrology at the University of California, Davis Children’s Hospital.

“Living donation transplantation is superior to deceased donor organ transplantation by allowing better matching and management of the organ obtained for transplant surgery,” Butani said in a university press release. .

“Evidence from our large observational study shows that organs from living related donors are significantly better than organs from deceased donors, while transplants from unrelated living donors appear to be at an intermediate risk between the two,” he said. he declares.

The researchers used data from the Organ Supply and Transplantation Network database from January 1, 2001 to September 30, 2021, comparing the rate of transplant failure between the three types of kidney donation. Transplant failure occurs when the organ is rejected by the recipient.

The research team compared the rates of transplant failure and death in 12,089 children who received their kidneys from living related donors, living unrelated donors and deceased donors during the 20-year study period. year.

The largest number, 7,413, received their kidneys from a deceased donor. Another 4,349 received a kidney from a living related donor, including 80% from parents, 6% from siblings and 13% from other relatives. Another 327 children received their kidney from an unrelated living donor.

Most of the participants were on dialysis before having their transplant. The study only included patients whose graft had not failed on the day of surgery.

The researchers found that transplants from deceased donors had the lowest graft survival after the first year at 4% compared to 2.8% from living related donors and 3.3% from living unrelated donors.

“Living donor transplants fare better than deceased donor transplants since the transplant can be planned,” Butani said. “This planning optimizes donor and recipient health and minimizes ischemia. [blocked blood supply] stress on the graft once it is obtained from the donor.”

The number of unrelated living donors also increased over the study period, from 1.3% in 1987 to 31.4% in 2017.

“Our analysis suggests that organ transplants from unrelated living donors are not inferior to organs from deceased donors,” said study co-author Daniel Tancredi, a professor in the UC Davis Department of Pediatrics. Health.

“This is especially important for children who are the most vulnerable of all and who have much to gain from receiving the best donor organ available,” he said in the statement.

The team also found that recipient age was a predictor of graft loss. Infants and preteens had a higher risk of transplant failure in the first year after transplant than teenagers. However, infants and tweens had a lower risk of graft failure after the first year post-transplant compared to adolescents.

The researchers also uncovered other factors of graft loss already well established in the study, including low albumin levels before transplantation and the need for dialysis before transplantation.

The results were recently published in the journal Pediatric transplant.

More information

The National Kidney Foundation has more on living donation.

SOURCE: University of California, Davis Health, press release, August 15, 2022

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