Donor Age and Ischemia Time Are Independent Factors Affecting Graft Survival after En Bloc Kidney Transplantation from Donors Less than Three Years of Age

This study aimed to investigate the outcomes of transplantation from donors aged less than three years in a single-center consecutive series. A total of 52 en bloc kidney graft transplantations were performed. In 22 cases, organs were procured from donors aged less than one year (group 1). In 30 cases, the age of donors varied from one to three years (group 2). After transplantation, renal function and graft and patient survival were evaluated retrospectively. No significant difference was observed between the groups regarding recipient age, time on dialysis, ischemia time, human leukocyte antigen matching, the time needed to reach serum creatinine levels of ≤2 mg/mL, and patient survival. Eight grafts were lost during the first six months after grafting in group 1, whereas only two grafts were lost in group 2. Immature glomeruli were observed in three preimplantation biopsy samples. Graft survival was significantly longer in group 2 (hazard ratio, 0.5 [95% CI, 0.28–0.91]; p = 0.025). In a multivariate analysis, donor age (p = 0.01) and ischemia time (p = 0.02) were independent factors affecting graft survival. En bloc kidney transplantation from donors aged less than one year was associated with high early graft loss and poor long-term survival rates. Further investigations are needed to confirm the possible relationship to the histological glomerular maturity.